PCSK9 and metabolic syndrome: Such associations were also observed in a study of 115 diabetic patients [40], yet another cohort of 267 patients with metabolic syndrome or type 2 diabetes displayed plasma PCSK9 levels that correlated positively not only with total cholesterol, but also with triglycerides and apolipoprotein B. Large VLDL, intermediate-density lipoprotein, small LDL and HDL particles and cholesterol in remnant lipoproteins are all atherogenic lipoproteins, and were positively associated with plasma PCSK9 levels [65].