PCSK9–dyslipidemia interplay in children and adolescents with type 1 diabetes: A potential modulator of vasculopathy

Document Type

Article

Publication Date

2026

Abstract

BACKGROUND Proprotein convertase subtilisin/kexin type-9 (PCSK9) has recently emerged as an important vasculopathy modulator. However, limited data exist on its level and expression in children and adolescents with type 1 diabetes (T1D). AIM To assess serum PCSK9 and gene expression among children and adolescents with T1D and correlate them with glycemia, dyslipidemia, and microvascular complications. METHODS Fifty children and adolescents with T1D were compared to 50 matched healthy controls. Serum PCSK9 enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) gene expression, glycated-hemoglobin, fundus, urinary albumin-to-creatinine ratio (uACR) and fasting lipids were assessed with calculation of the estimated-glucose disposal rate (eGDR). RESULTS Children and adolescents with T1D, particularly those with microvascular complications, have significantly higher PCSK9 and PCSK9 gene expression than controls (P < .05). Serum PCSK9 and PCSK9 gene expression were significantly correlated with diabetes-duration, insulin dose, time above range (TAR), diastolic blood pressure percentile, low-density lipoprotein cholesterol (LDL-C) and uACR (P < .05), being independently correlated with diabetes-duration, LDL-C, and uACR using multivariate regression. CONCLUSION Serum PCSK9 and PCSK9 gene expression are elevated among children and adolescents with T1D showing significant association with dyslipidemia and microvascular complications. Further studies are warranted to explore the potential role of PCSK9 inhibitors in prevention and treatment of dyslipidemia and vasculopathy in T1D.

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