Related Experiment Video

Updated: May 9, 2026

Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
07:29

Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein

Published on: October 12, 2017

The role of bilirubin and its protective function against coronary heart disease

A Erkan1, B Ekici, M Uğurlu

  • 1Ufuk University School of Medicine, Mevlana Bulvarı 86-88, Balgat, 06520, Ankara, Turkey, aycanfahri@gmail.com.

Herz
|July 18, 2013
PubMed

Insights

Bilirubin, an antioxidant, may not protect against coronary artery disease (CAD) in individuals with multiple risk factors. Direct bilirubin showed a positive correlation with CAD severity, suggesting limited protective effects in high-risk populations.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Medical Research

Background:

  • Atherosclerotic cardiovascular disease (ASCVD) is a leading global cause of death.
  • Atherosclerosis involves lipid peroxidation, and bilirubin is an endogenous antioxidant with potential antiatherosclerotic properties.
  • Previous studies suggest an inverse relationship between serum bilirubin and coronary artery disease (CAD) risk.

Purpose of the Study:

  • To investigate the antiatherosclerotic effects of bilirubin in a population with multiple cardiovascular risk factors.
  • To assess the relationship between serum bilirubin levels and the severity of CAD as indicated by the Gensini score.

Main Methods:

  • The study included 221 patients undergoing coronary angiography.
  • 145 patients with documented CAD and multiple risk factors were compared to 76 controls.
  • Serum total and direct bilirubin levels were measured, and CAD severity was quantified using the Gensini score.

Main Results:

  • Patients with CAD had significantly more cardiovascular risk factors than controls.
  • Serum total and direct bilirubin levels did not differ significantly across control, minimal CAD, and significant CAD groups.
  • A moderate positive correlation was found between direct bilirubin levels and the Gensini score (r=0.158, p=0.019).

Conclusions:

  • In individuals with multiple cardiovascular risk factors, serum bilirubin concentrations may not provide the same level of protection against CAD.
  • The observed correlation between direct bilirubin and CAD severity is unlikely to be causative, considering bilirubin's known antioxidant effects.
Abstract

Related Concept Videos

Jaundice01:25

Jaundice

Jaundice, or icterus, is the yellow discoloration of the skin, sclerae, and mucous membranes. It happens when plasma bilirubin levels rise above 2.5-3 mg/dL, leading to bilirubin deposition in tissue.Bilirubin is a byproduct of hemoglobin degradation. In macrophages, hemoglobin breaks down into globin and heme. Globin is converted into amino acids, while heme is turned into biliverdin by heme oxygenase, which is then reduced to unconjugated bilirubin by biliverdin reductase.Unconjugated...
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Cholesterol: Significance and Regulation01:29

Cholesterol: Significance and Regulation

Although not a source of energy, cholesterol plays a significant role as a foundational structure for bile salts, steroid hormones, and vitamin D, as well as being a crucial component of plasma membranes. Approximately 15% of blood cholesterol is derived from our diet, with the remainder synthesized from acetyl CoA by the liver and intestines. Cholesterol is eliminated from the body through its conversion into bile salts, which are eventually discarded in the feces.
Considering cholesterol and...
Liver Physiology01:30

Liver Physiology

The liver, an essential organ in the human body, performs over 200 vital functions that can be broadly categorized into metabolic, hematological, endocrine regulation, and bile production.
Metabolic Regulation:
The liver is the central organ involved in regulating blood composition. It stabilizes blood glucose levels, maintaining them within the range of  70–110 mg/dL. When these levels drop, the liver breaks down glycogen reserves and releases glucose into the bloodstream. It can also...
Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...