A Spectrum of PCSK9 Alleles Contributes to Plasma Levels of Low-Density Lipoprotein Cholesterol
Open accessAbstract
Selected missense mutations in the proprotein convertase subtilisin/kexin type 9 serine protease gene (PCSK9) cause autosomal dominant hypercholesterolemia, whereas nonsense mutations in the same gene are associated with low plasma levels of low-density lipoprotein cholesterol (LDL-C). Here, DNA sequencing and chip-based oligonucleotide hybridization were used to determine whether other sequence variations in PCSK9 contribute to differences in LDL-C levels. The coding regions of PCSK9 were sequenced in the blacks and whites from the Dallas Heart Study (n=3,543) who had the lowest (<5th percentile) and highest (>95th percentile) plasma levels of LDL-C. Of the 17 missense variants identified, 3 (R46L, L253F, and A443T) were significantly and reproducibly associated with lower plasma levels of LDL-C (reductions ranging from 3.5% to 30%). None of the low-LDL-C variants were associated with increased hepatic triglyceride content, as measured by proton magnetic resonance spectroscopy. This finding is most consistent with the reduction in LDL-C being caused primarily by accelerating LDL clearance, rather than by reduced lipoprotein production. Association studies with 93 noncoding single-nucleotide polymorphisms (SNPs) at the PCSK9 locus identified 3 SNPs associated with modest differences in plasma LDL-C levels. Thus, a spectrum of sequence variations ranging in frequency (from 0.2% to 34%) and magnitude of effect (from a 3% increase to a 49% decrease) contribute to interindividual differences in LDL-C levels. These findings reveal that PCSK9 activity is a major determinant of plasma levels of LDL-C in humans and make it an attractive therapeutic target for LDL-C lowering.
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The gene encoding PCSK9 contains very rare mutations causing autosomal dominant hypercholesterolemia and high-frequency common variants with modest effects.
“The gene encoding PCSK9 contains very rare mutations causing autosomal dominant hypercholesterolemia (discovered by linkage analysis), as well as high-frequency common variants with modest effects.”
From Genetic Mapping in Human Disease (2008) · cites this paper as [126]
Hobbs and Cohen identified low-frequency common variants in PCSK9 at 0.5 to 1%, which allowed epidemiological research documenting a protective effect on myocardial infarction.
“Hobbs and Cohen sequenced the gene (126, 127) and identified low-frequency common variants (0.5 to 1%), which allowed epidemiological research documenting a protective effect on myocardial infarction (128).”
From Genetic Mapping in Human Disease (2008) · cites this paper as [126]
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- Authors
- Kotowski, I. K., Pertsemlidis, A., Luke, A., Cooper, R. S., Vega, G. L., Cohen, J. C., & Hobbs, H. H.
- Affiliations
- Howard Hughes Medical Institute (US)
- Loyola University Medical Center (US)
- Corresponding author
- Hobbs, Helen H.
- Venue
- The American Journal of Human Genetics
- Publisher
- Elsevier BV
- Published
- 2006-03
- Volume
- 78
- Issue
- 3
- Pages
- 410-422
- ISSN
- 0002-9297 (ISSN-L)
- OpenAlex
- W2110124859
- Cited by
- 517
- References
- 38
- Citations by year
- 2026: 13 · 2025: 8 · 2024: 10 · 2023: 13 · 2022: 15 · 2021: 18 · 2020: 19 · 2019: 30 · 2018: 26 · 2017: 24 · 2016: 23 · 2015: 34 · 2014: 35 · 2013: 22 · 2012: 26
- FWCI
- 44.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The American Journal of Human Genetics (publishedVersion)
- PubMed (publishedVersion)
- Civil War Book Review (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs
- Donald W. Reynolds Foundation
- National Heart, Lung, and Blood Institute (HL-20948, P01HL020948)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- PCSK9, LDL cholesterol, missense mutations, LDL cholesterol lowering, autosomal dominant hypercholesterolemia, LDL clearance, hepatic triglyceride content, single nucleotide polymorphisms, genetic variants, Dallas Heart Study, LDL-C lowering therapy
- MeSH terms
- Proprotein Convertase 9, Alleles, Amino Acid Sequence, Female, Gene Frequency, Haplotypes, Humans, Hypercholesterolemia, Cholesterol, LDL, Male, Molecular Sequence Data, Mutation, Serine Endopeptidases, Evolution, Molecular, Polymorphism, Single Nucleotide, Proprotein Convertases
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