Supplementation with Octacosanol Affects the Level of PCSK9 and Restore Its Physiologic Relation with LDL-C in Patients on Chronic Statin Therapy

Nutrients. 2021 Mar 10;13(3):903. doi: 10.3390/nu13030903.


Dietary supplementation with sugar cane derivates may modulate low-density lipoprotein cholesterol (LDL-C) and proprotein convertase subtilisin/kexin type 9 (PCSK9) levels. The purpose of this study was to determine if dietary supplement (DS), containing Octacosanol (20 mg) and vitamin K2 (45 µg), could restore the disrupted physiologic relation between LDL-C and serum PCSK9. Double-blind, randomized, placebo-controlled, single-center study including 87 patients on chronic atorvastatin therapy was conducted. Eighty-seven patients were randomized to receive DS (n = 42) or placebo (n = 45), and followed for 13 weeks. Serum PCSK9 levels, lipid parameters and their relationship were the main efficacy endpoints. The absolute levels of PCSK9 and LDL-C were not significantly different from baseline to 13 weeks. However, physiologic correlation between % change of PCSK9 and % change of LDL-C levels was normalized only in the group of patients treated with DS (r = 0.409, p = 0.012). This study shows that DS can restore statin disrupted physiologic positive correlation between PCSK9 and LDL-C. Elevated PCSK9 level is an independent risk factor so controlling its rise by statins may be important in prevention of cardiovascular events.

Keywords: LDL-C; Octacosanol; PCSK9; statins; supplementation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticholesteremic Agents / therapeutic use
  • Atorvastatin / therapeutic use
  • Cholesterol, LDL / blood*
  • Dietary Supplements*
  • Double-Blind Method
  • Dyslipidemias / drug therapy
  • Fatty Alcohols / administration & dosage*
  • Female
  • Humans
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / drug therapy
  • Male
  • Middle Aged
  • Proprotein Convertase 9 / blood*
  • Vitamin K 2 / administration & dosage
  • Vitamins / administration & dosage


  • Anticholesteremic Agents
  • Cholesterol, LDL
  • Fatty Alcohols
  • Vitamins
  • Vitamin K 2
  • 1-octacosanol
  • Atorvastatin
  • PCSK9 protein, human
  • Proprotein Convertase 9