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A protective effect of PCSK9 against cancer growth and metastasis in vitro and in vivo has also been reported for hepatocellular carcinoma (He et al., 2021), whereas increased development of hepatic cancer has been seen in PCSK9 knockout mice injected with hepatic carcinogen diethylnitrosamine than wild-type mice (Ioannou et al., 2022)

One thing that could cause this decline is a decrease in blood flow through your body, a process called intermittent claudication

Connerton, 1989