title: Stairs instead of elevators at the workplace decreases PCSK9 levels in a healthy population.
abstract: BACKGROUND
  Regular physical activity is recommended to lower low-density lipoprotein cholesterol (LDL-C) in a healthy population. Inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) was shown to reduce (LDL-C) levels; however, the impact of physical exercise on PCSK9 levels remains unclear.
  
  
  METHODS
  We used data from 67 healthy hospital employees who participated in a 6-month intervention promoting active use of stairs instead of elevators during 3 months, followed by 3 months without recommendation. We confirmed the degree of physical activity with estimated aerobic capacity (VO2 max ) and measured serum PCSK9 levels at baseline, 3 and 6 month. Using a multilevel regression model, we analysed changes of PCSK9 levels over time adjusting for age, gender, aerobic capacity, baseline LDL-C, and LDL-C and body mass index (BMI) changes.
  
  
  RESULTS
  At baseline, PCSK9 levels were associated with higher aerobic capacity (P-value = 0·024). At 3 months, we observed a significant decrease in mean PCSK9 levels from 403·6 to 324·3 ng/mL (P-value = 0·001), as well a significant decrease in mean LDL-C levels from 3·5 to 3·3 mM (P-value = 0·01). During this period, mean aerobic capacity (VO2 max ) increased from 37·0 to 40·4 mL/kg/min (P-value < 0·001). Physical activity was independently associated with a decrease in PCSK9 levels after adjustment for age, gender, baseline aerobic capacity, and LDL-C and BMI changes.
  
  
  CONCLUSIONS
  Daily physical activity at the work place is independently associated with a decrease in PCSK9 levels over time.
authors.affiliation: Division of Cardiology, Department of Medical Specialties, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
authors.forename: Christel H
authors.initials: CH
authors.lastname: Kamani
authors.affiliation: Division of Cardiology, Department of Medical Specialties, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
authors.forename: Baris
authors.initials: B
authors.lastname: Gencer
authors.affiliation: Division of Cardiology, Department of Medical Specialties, Geneva University Hospital, University of Geneva, Geneva, Switzerland.|Department of Internal Medicine, University of Genoa School of Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy.|Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montecucco
authors.affiliation: Division of Clinical Epidemiology, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
authors.forename: Delphine
authors.initials: D
authors.lastname: Courvoisier
authors.affiliation: Division of Laboratory Medicine, Department of Genetics and Laboratory Medicine, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Vuilleumier
authors.affiliation: Division of Cardiology, Department of Medical Specialties, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Meyer
authors.affiliation: Division of Cardiology, Department of Medical Specialties, Geneva University Hospital, University of Geneva, Geneva, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Mach
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D004607:Elevators and Escalators; D015444:Exercise / Q000502:physiology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases / Q000378:metabolism*; D012697:Serine Endopeptidases / Q000378:metabolism*; D017132:Workplace
chemical_list: D015415:Biomarkers; C472125:PCSK9 protein, human; D000071449:Proprotein Convertase 9; D043484:Proprotein Convertases; D012697:Serine Endopeptidases
keywords: Biomarkers; PCSK9; lifestyle intervention; lipids; physical exercise