Serum proprotein convertase subtilisin/kexin type 9 levels correlate with depression severity in post-stroke patients

Table 1 Baseline characteristics of the study participants

Characteristic	Treatment group (n = 64)	Control group (n = 64)	P value
Age (years)	65.3 ± 10.8	66.1 ± 11.2	0.685
Sex (female, %)	52.5	48.4	0.638
Education (college or higher, %)	34.4	32.3	0.799
NIHSS score at admission	7.2 ± 2.1	7.1 ± 2.0	0.774
History of hypertension (%)	68.8	65.6	0.683
History of diabetes (%)	28.1	26.6	0.837
Smoking history (%)	32.8	29.7	0.688
Baseline HAMD-17 score	22.8 ± 4.5	22.3 ± 4.2	0.516
Baseline HAMA score	18.6 ± 4.2	18.1 ± 3.9	0.478
Baseline MoCA score	22.5 ± 3.2	22.3 ± 3.1	0.715

HAMD-17: 17-item Hamilton Depression Rating Scale; NIHSS: National Institutes of Health Stroke Scale; HAMA: Hamilton Anxiety Scale; MoCA: Montreal Cognitive Assessment.

Table 2 Changes in serum proprotein convertase subtilisin/kexin type 9 concentrations over 12 weeks

Time point	Treatment group (ng/mL)	Control group (ng/mL)	P value
Baseline	385.6 ± 78.4	378.2 ± 76.9	0.587
4 weeks	245.7 ± 58.3	365.8 ± 72.1	< 0.001
8 weeks	192.5 ± 48.6	321.4 ± 69.5	< 0.001
12 weeks	156.3 ± 42.1	298.5 ± 68.7	< 0.001

Table 3 Changes in depression and anxiety scores over 12 weeks

Outcome measure	Treatment group	Control group	P value
HAMD-17 score at baseline	22.8 ± 4.5	22.3 ± 4.2	0.516
HAMD-17 score at 4 weeks	18.3 ± 3.8	19.6 ± 3.9	0.076
HAMD-17 score at 8 weeks	13.7 ± 3.5	16.8 ± 3.7	< 0.001
HAMD-17 score at 12 weeks	10.2 ± 3.1	14.6 ± 3.8	< 0.001
HAMA score at 12 weeks	8.5 ± 2.3	12.1 ± 3.2	< 0.001
Treatment response rate (%)	73.4 (45/61)	48.4 (30/62)	0.003
Remission rate (HAMD-17 < 7, %)	52.5 (32/61)	29.0 (18/62)	0.007

HAMD-17: 17-item Hamilton Depression Rating Scale; HAMA: Hamilton Anxiety Scale.

Table 4 Inflammatory markers and lipid profiles at 12 weeks

Indicator	Treatment group (12 weeks)	Control group (12 weeks)	P value
IL-6 (pg/mL)	3.2 ± 0.8	5.1 ± 1.2	< 0.001
TNF-α (pg/mL)	8.4 ± 1.6	12.3 ± 2.1	< 0.001
hs-CRP (mg/L)	2.8 ± 0.9	4.3 ± 1.3	< 0.001
LDL-cholesterol (mmol/L)	1.4 ± 0.4	2.1 ± 0.6	< 0.001
Total cholesterol (mmol/L)	3.6 ± 0.7	4.3 ± 0.8	< 0.001
HDL-cholesterol (mmol/L)	1.2 ± 0.3	1.2 ± 0.3	0.856
Triglycerides (mmol/L)	1.5 ± 0.6	1.6 ± 0.7	0.412

IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; hs-CRP: High-sensitivity C-reactive protein; LDL: Low-density lipoprotein; HDL: High-density lipoprotein.

Table 5 Cognitive and functional outcomes

Outcome measure	Treatment group	Control group	P value
MoCA score at baseline	22.5 ± 3.2	22.3 ± 3.1	0.715
MoCA score at 12 weeks	25.8 ± 2.1	23.4 ± 2.6	0.001
mRS 0-2 at 12 weeks (%)	63.9	46.8	0.047
Mean mRS at 12 weeks	2.1 ± 1.0	2.6 ± 1.1	0.011
Barthel Index at baseline	65.4 ± 18.2	64.8 ± 17.9	0.854
Barthel Index at 12 weeks	82.3 ± 14.6	75.4 ± 16.8	0.015

MoCA: Montreal Cognitive Assessment; mRS: Modified Rankin Scale.

Table 6 Correlations between serum proprotein convertase subtilisin/kexin type 9 concentrations and clinical outcomes

Correlation analysis	Pearson r	P value
PCSK9 vs HAMD-17 at baseline	0.428	< 0.001
PCSK9 vs HAMD-17 at 4 weeks	0.512	< 0.001
PCSK9 vs HAMD-17 at 8 weeks	0.589	< 0.001
PCSK9 vs HAMD-17 at 12 weeks	0.652	< 0.001
PCSK9 vs HAMA at 12 weeks	0.587	< 0.001
PCSK9 vs IL-6 at 12 weeks	0.543	< 0.001
PCSK9 vs TNF-α at 12 weeks	0.498	< 0.001
PCSK9 vs MoCA at 12 weeks	-0.456	< 0.001

PCSK9: Proprotein convertase subtilisin/kexin type 9; HAMD-17: 17-item Hamilton Depression Rating Scale; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-α; MoCA: Montreal Cognitive Assessment; HAMA: Hamilton Anxiety Scale.