It has been shown that low PCSK9 levels are associated with the presence of metabolic syndrome and atherosclerosis in patients with coronary heart disease [27] and recently, a study conducted by Peng et al. described an important relationship between elevated circulating PCSK9 levels to be associated with higher cardiovascular morbidity and adverse cardiovascular outcomes specifically in patients with diabetes [28]. Here, PCSK9 is linked to atherosclerosis.