The impact of sex on the levels of PCSK9 was even more evident when at least one complication was present, namely, higher levels PCSK9 were found in women with at least one complication compared to women without additional complications and compared to males with either uncomplicated (p = 0.022) or complicated (p < 0.001) T2DM (Fig. 1B, Additional file 1: Table S1). Here, PCSK9 is linked to type 2 diabetes mellitus.