PCSK9 and metabolic syndrome: Indeed, genetic variants significantly associated with dyslipidemia have already been identified: in a Canadian study, loss of gene function was found in the Caucasian population but not in the population of African origin.31,32 Considering these observations, our study suggests that the relationship between PCSK9 and dyslipidemia in black Africans undergoing hemodialysis may be due to a genetic predisposition that could be gains-of-function of PCSK9 in these patients.