The negative association of PCSK9 with liver disease is intuitive given the role of PCSK9 with hepatic cholesterol metabolism- PCSK9 is intimately involved in cholesterol metabolism, by binding to the EGF-A domain of the low-density lipoprotein receptor (LDLR) and targeting it for lysosomal-mediated degradation (22). Here, PCSK9 is linked to liver disorder.