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We hypothesized that hyperlipidemic factors, for which inhibitors are already available and used to treat cardiovascular disease, would be dysregulated in metastatic PCa (mPCa). The goal of this case-control study, including 35 men per group, was to compare the levels of PCSK9, ANGPTL3, Apo CIII, leptin, and the lipid profile in patients with mPCa versus localized Gleason 8\/9 PCa (lPCa) and patients at risk of developing PCa (controls). Methods: Protein levels were assessed using ELISAs, while lipids were measured using the Roche Cobas analytical platform. Results: The following circulating analytes were higher in mPCa: triglycerides (in mmol\/L; controls 1.7 \u00b1 1.2, lPCa 1.5 \u00b1 0.7, mPCa 2.3 \u00b1 1.2, p = 0.0004), Apo CIII (in \u00b5g\/mL; control 110.7 \u00b1 55.7, lPCa 115.0 \u00b1 57.64, mPCa 159.9 \u00b1 96.7, p = 0.0179), ANGPTL3 (in ng\/mL; controls 41.7 \u00b1 20.0, lPCa 42.8 \u00b1 24.1, mPCa 57.3 \u00b1 26.9, p = 0.0390), and leptin (in ng\/mL, controls 9.6 \u00b1 9.1, lPCa 8.2 \u00b1 7.9, mPCa 17.7 \u00b1 17.8, p &lt; 0.0001). Surprisingly, PCSK9 levels were negatively correlated with LDL in the entire cohort. Conclusions: In this cohort of men, whole-body lipid metabolic rewiring is a feature restricted to the metastatic phase of prostate cancer, suggesting it may play a significant role in the progression toward more aggressive cancer forms. Given the availability of drugs targeting ANGPTL3 and Apo CIII, the therapeutic potential of these drugs should be evaluated in metastatic PCa.<\/jats:p>","DOI":"10.3390\/cancers18071176","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T09:40:31Z","timestamp":1775554831000},"page":"1176","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["ANGPTL3, Apo CIII, Leptin and Triglycerides Are Elevated in Metastatic Prostate Cancer"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-0202-5874","authenticated-orcid":false,"given":"Gabriel","family":"Boulay","sequence":"first","affiliation":[{"name":"Facult\u00e9 de Pharmacie, Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 0A6, Canada"},{"name":"Axe Oncologie, Centre de Recherche du CHU de Qu\u00e9bec\u2013Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 4G2, Canada"},{"name":"Axe Neurosciences, Centre de Recherche du CHU de Qu\u00e9bec\u2013Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 4G2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan","family":"Khodr","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 0A6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann-Charlotte","family":"Bergeron","sequence":"additional","affiliation":[{"name":"Axe Oncologie, Centre de Recherche du CHU de Qu\u00e9bec\u2013Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 4G2, Canada"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 0A6, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5892-2986","authenticated-orcid":false,"given":"\u00c9milie","family":"Wong Chong","sequence":"additional","affiliation":[{"name":"Axe Oncologie, Centre de Recherche du CHU de Qu\u00e9bec\u2013Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 4G2, Canada"},{"name":"Facult\u00e9 de M\u00e9decine, Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 0A6, Canada"},{"name":"Centre de Recherche sur le Cancer (CRC)\u2013Universit\u00e9 Laval, Qu\u00e9bec City, QC G1J 0J9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"France-H\u00e9l\u00e8ne","family":"Joncas","sequence":"additional","affiliation":[{"name":"Axe Oncologie, Centre de Recherche du CHU de Qu\u00e9bec\u2013Universit\u00e9 Laval, Qu\u00e9bec City, QC G1V 4G2, Canada"},{"name":"Centre de Recherche sur le Cancer (CRC)\u2013Universit\u00e9 Laval, Qu\u00e9bec City, QC G1J 0J9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6430-5241","authenticated-orcid":false,"given":"Chlo\u00e9","family":"Castonguay","sequence":"additional","affiliation":[{"name":"Axe Oncologie, Centre de Recherche du CHU de Qu\u00e9bec\u2013Universit\u00e9 Laval, 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