The Lipid-lowering Efficacy And Anti-inflammatory Effects Of PCSK9 Inhibitors In Patients With Dyslipidemia In Type 2 Diabetes

Objective: As a new type of lipid-lowering drug,PCSK9 inhibitors have been widely used internationally in patients with high cardiovascular disease risk who need to further reduce cholesterol levels,but their lipid-lowering efficacy and anti-inflammatory effects in domestic type 2 diabetes patients is still not clear,and there are many opinions on the effects of traditional lipid-lowering drugs such as statins and PCSK9 inhibitors on blood glucose.The study evaluate the control of two drugs on the blood glucose of diabetic patients by observing the fasting,2h postprandial blood glucose and Hb A1 c of patients,and detect the TC,TG,LDL-C and Lp(a)levels of patients with this type of dyslipidemia to know lipid-lowering efficacy,while measuring the changes of IL-1,IL-6 and TNF-? to explore the anti-inflammatory effects and mechanisms of PCSK9 inhibitors,it is expected to increase clinical application value of the drug.Methods: Select patients who attended the Endocrinology Department of Handan First Hospital from February 2019 to December 2019,and were included in the trial according to the selection criteria.For all patients who were selected to meet the criteria,fasting venous blood was drawn before the medication.The control group For the statin group,20 mg of atorvastatin was given once a night,and the study group was the combination of statin and PCSK9 inhibitor.The usage and dosage of statin remained unchanged,and the PCSK9 inhibitor was given 140 mg subcutaneously every 2 weeks.The inflammatory factors IL-1,IL-6,TNF-?,blood lipid levels TC,TG,LDL-C,Lp(a),fasting and 2h postprandial blood glucose and Hb A1 c were compared and analyzed before and after treatment.Use SPSS23.0 statistical software to process data.?2 test was used for counting data.The measurement data were expressed by the mean ± standard deviation method using t test,and P<0.05 was considered as statistically significant.Results: Compared with the statin group,the PCSK9 inhibitor combined with the statin group can significantly reduce TG,TC,and LDL-C before and after treatment(P<0.05),but the PCSK9 inhibitor combined group reduces TG,TC,and LDL-C level was statistically significant(P<0.05);compared with the statin group in the PCSK9 inhibitor combined with statin group,fasting,2h postprandial blood glucose and Hb A1 c were not statistically significant before and after treatment(P>0.05);Compared with the statin group,the PCSK9 inhibitor combined with the statin group had statistically significant inhibitory effects on IL-1,IL-6,and TNF-? before and after treatment(P<0.05).The PCSK9 inhibitor combined with the statin group was significant statistical significance(P<0.05).Conclusion: For patients with type 2 diabetes with dyslipidemia,PCSK9 inhibitors can significantly reduce the levels of TG,TC,and LDL-C based on the background treatment of statins;PCSK9 inhibitors have no significant effect on blood glucose control;The inhibitory effect of PCSK9 inhibitors on IL-1,IL-6,and TNF-? is better than that of statins alone,but the mechanism of its anti-inflammatory effect is not yet clear.