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Serum bilirubin and cardiovascular risk factors in a Chinese population
1Department of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T. Hong Kong.
Insights
Low serum bilirubin levels are linked to increased cardiovascular disease risk factors, including obesity and abnormal glucose tolerance. Further research is needed to clarify these associations and potential metabolic links.
Area of Science:
- Biochemistry
- Cardiology
- Endocrinology
Background:
- Cardiovascular disease (CVD) risk factors are well-established.
- Emerging research suggests a link between low serum bilirubin and increased CVD risk.
- Further investigation into this association is warranted due to limited existing data.
Purpose of the Study:
- To examine the relationship between serum bilirubin concentrations and various cardiovascular disease risk factors in a Hong Kong Chinese population.
- To investigate the association between serum bilirubin levels and glucose metabolism, including abnormal glucose tolerance.
Main Methods:
- A study involving 1508 Hong Kong Chinese participants.
- Participants were categorized into four groups based on serum bilirubin levels (quartiles).
- Evaluated associations with risk factors like age, sex, smoking, obesity, glycaemic status, and lipid profiles.
Main Results:
- Lower serum bilirubin correlated with increased age, smoking, higher body mass index, blood pressure, and unfavorable lipid profiles.
- Inverse correlations were observed between serum bilirubin and fasting insulin, triglycerides, and glycated hemoglobin.
- Subjects with abnormal glucose tolerance exhibited significantly lower mean serum bilirubin concentrations compared to normal subjects.
Conclusions:
- Low serum bilirubin is associated with multiple cardiovascular disease risk factors.
- Reduced serum bilirubin levels are observed in individuals with abnormal glucose tolerance.
- Potential underlying mechanisms may involve abnormal intermediary metabolism and antioxidant deficiency, requiring further research.
Background:
Many risk factors for cardiovascular disease (CVD) have been identified. Recently an association between low concentration of serum bilirubin and increased risk of CVD has been reported. However, information on this topic remains scarce.
Methods:
We examined the relationships between serum bilirubin and CVD risk factors in 1508 Hong Kong Chinese. We divided the subjects into four quartiles based on serum bilirubin concentrations. Cardiovascular risk factors studied include age, sex, smoking, obesity glycaemic status and lipid indices.
Results:
Decreasing serum bilirubin concentration was associated with older age, increased prevalence of smoking, higher body mass index and systolic blood pressure, increased glycated haemoglobin, fasting and 2 h insulin, triglyceride, very-low-density lipoprotein and apolipoprotein B concentrations, and lower high-density lipoprotein concentration. Women had lower bilirubin concentrations than men. After adjustment for age, sex, smoking and insulin levels as covariates, the associations between serum bilirubin concentration and glycated haemoglobin, triglyceride, high-density lipoprotein and very-low-density lipoprotein persisted. The prevalence rates of abnormal glucose tolerance (impaired glucose tolerance or diabetes) were similar amongst the four quartiles of bilirubin concentrations. However, the mean bilirubin concentration was significantly lower in subjects with abnormal glucose tolerance (9.3 +/- 3.5 mumol/l, n = 178) than in normal subjects (10.1 +/- 5.2 mumol/l, n = 1330, P = 0.039). When analysed as a continuous variable by age-adjusted partial correlation coefficients, serum bilirubin concentration was inversely correlated with fasting insulin, triglyceride, very-low-density lipoprotein and glycated haemoglobin level.
Conclusions:
There were close associations between low serum bilirubin concentration and increased CVD risk factors. Subjects with abnormal glucose tolerance also had lower serum bilirubin concentration than normal subjects. Some of these associations (body mass index, systolic blood pressure) could be explained by differences in insulin level. These relationships between bilirubin and CVD risk factors require further clarification, although abnormal intermediary metabolism and antioxidant deficiency may be possible linking factors.