Serum bilirubin and risk of ischemic heart disease in middle-aged British men

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L H Breimer1, G Wannamethee, S Ebrahim

  • 1Department of Clinical Pathology, Royal Free Hospital School of Medicine, London, UK.

Clinical Chemistry
|October 1, 1995
PubMed

Insights

Low serum bilirubin levels may increase ischemic heart disease risk. A study found a U-shaped relationship between bilirubin and heart disease, suggesting a potential role for antioxidants.

Area of Science:

  • Cardiology
  • Biochemistry
  • Epidemiology

Background:

  • Serum bilirubin, a byproduct of heme metabolism, has been investigated for its potential antioxidant properties.
  • Previous research has yielded conflicting results regarding the association between serum bilirubin levels and cardiovascular disease risk.
  • Understanding the relationship between bilirubin and ischemic heart disease (IHD) is crucial for identifying novel risk factors and preventive strategies.

Purpose of the Study:

  • To investigate the association between serum bilirubin concentrations and the risk of major ischemic heart disease (IHD) events in middle-aged British men.
  • To determine if a specific relationship, such as a U-shaped curve, exists between serum bilirubin levels and IHD risk.
  • To explore the influence of other cardiovascular risk factors on this potential association.

Main Methods:

  • A prospective study involving 7685 middle-aged British men was conducted.
  • Data on serum bilirubin levels and major IHD events were collected over an 11.5-year follow-up period.
  • Statistical analyses were performed to examine the relationship between bilirubin concentrations and IHD risk, adjusting for relevant cardiovascular risk factors.

Main Results:

  • A U-shaped relationship was observed between serum bilirubin levels and the risk of IHD.
  • Men in the middle range of serum bilirubin (8-9 mumol/L) exhibited a 30% reduced relative risk of IHD compared to those in the lowest fifth (< 7 mumol/L).
  • Low bilirubin concentrations were associated with traditional cardiovascular risk factors including smoking, low high-density lipoprotein cholesterol, and reduced lung function.

Conclusions:

  • The observed U-shaped relationship suggests that both low and very high serum bilirubin levels may be associated with an increased risk of IHD.
  • The findings support the hypothesis that endogenous antioxidants, potentially including bilirubin, play a role in the etiology of IHD.
  • Further research is warranted to elucidate the mechanisms underlying this association and its clinical implications.

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