Novotný Ladislav, Vítek Libor
EuroMISE Center-Cardio and Institute of Hygienic Medicine and Epidemiology, 1st Medical Faculty, Charles University, Prague, Czech Republic.
Exp Biol Med (Maywood). 2003 May;228(5):568-71. doi: 10.1177/15353702-0322805-29.
Bilirubin, a major intravascular product of heme catabolism, is a potent antioxidant compound. Numerous studies have been published showing the relationship between serum bilirubin levels and atherosclerosis. In the present investigation all the epidemiological studies available on the effect of serum bilirubin levels and atherosclerotic disease were analyzed. Studies on the epidemiology of atherosclerotic diseases in relation to serum bilirubin levels were searched in the MEDLINE database. Selected studies were subdivided according to serum bilirubin levels and severity of atherosclerotic disease. Because of the limited number of females involved in the studies, only males were included into meta-analysis. Associations for ordered categorical variables (bilirubin and natural history of graded atherosclerosis) were assessed to find correlation and linear trend between analyzed variables. A stratified analysis was conducted to compare risks of clinical outcomes. Eleven relevant studies were used for analysis. A close negative relationship was found between serum bilirubin levels and severity of atherosclerosis (Spearman rank coefficient r = -0.31,P < 0.0001). The linear trend was confirmed in analysis of proportions with x(2) values for both disease conditions to be very significant (P < 0.0001). Unambiguous inverse relationship between serum bilirubin levels and atherosclerosis was demonstrated in this preliminary meta-analytic study. These results indicate the importance of hem oxygenase-related products in the prevention of oxidative stress-mediated diseases.
胆红素是血红素分解代谢的一种主要血管内产物，是一种强效抗氧化化合物。已有大量研究发表，表明血清胆红素水平与动脉粥样硬化之间的关系。在本研究中，对所有关于血清胆红素水平与动脉粥样硬化疾病影响的流行病学研究进行了分析。在MEDLINE数据库中检索了关于血清胆红素水平与动脉粥样硬化疾病流行病学的研究。根据血清胆红素水平和动脉粥样硬化疾病的严重程度对所选研究进行细分。由于参与研究的女性数量有限，仅将男性纳入荟萃分析。评估有序分类变量（胆红素与分级动脉粥样硬化的自然史）之间的关联，以发现分析变量之间的相关性和线性趋势。进行分层分析以比较临床结局的风险。使用11项相关研究进行分析。发现血清胆红素水平与动脉粥样硬化严重程度之间存在密切的负相关（Spearman等级系数r = -0.31，P < 0.0001）。在对两种疾病状态的比例分析中，线性趋势得到证实，x²值非常显著（P < 0.0001）。在这项初步的荟萃分析研究中，证实了血清胆红素水平与动脉粥样硬化之间存在明确的负相关关系。这些结果表明血红素加氧酶相关产物在预防氧化应激介导的疾病中的重要性。
