低血清胆红素水平在男性和女性中均与血流介导的血管舒张功能受损及颈动脉内膜中层厚度增加独立且呈负相关。

Low serum bilirubin levels are independently and inversely related to impaired flow-mediated vasodilation and increased carotid intima-media thickness in both men and women.

作者信息

Erdogan Dogan, Gullu Hakan, Yildirim Erkan, Tok Derya, Kirbas Ismail, Ciftci Ozgur, Baycan Semra Topcu, Muderrisoglu Haldun

机构信息

Baskent University, Faculty of Medicine, Cardiology Department, Konya, Turkey.

出版信息

Atherosclerosis. 2006 Feb;184(2):431-7. doi: 10.1016/j.atherosclerosis.2005.05.011. Epub 2005 Jun 23.

DOI:10.1016/j.atherosclerosis.2005.05.011

PMID:15979081

Abstract

BACKGROUND

Elevated levels of low-density lipoprotein (LDL) cholesterol and its oxidative modification have been described to be involved in the process of atherogenesis. Bilirubin, an antioxidant, prevents oxidative modification of LDL and therefore may protect from atherosclerosis and coronary heart disease (CHD). Impaired brachial artery flow-mediated dilatation (FMD), which means endothelial dysfunction (ED) and carotid intima-media thickness (IMT) are predictors for the development and progression of atherosclerosis. In the present study, FMD and IMT were studied in healthy subjects with lower and higher serum bilirubin concentrations in physiological ranges.

METHODS

Ninety-one healthy subjects between 25 and 45 years of age (47 with lower and 44 with higher serum bilirubin concentrations) were included in this study. Carotid IMT and brachial artery flow-mediated dilatation was measured by means of high-resolution vascular ultrasound. FMD was assessed by establishing reactive hyperemia and endothelium-independent dilatation (EID) was determined by using sublingual isosorbide dinitrate.

RESULTS

EDD in subjects with lower serum bilirubin concentrations was significantly worse than in those with higher serum bilirubin concentrations (11.6+/-4.4% versus 7.2+/-4.7%, respectively, p<0.0001). EID measurements were not significantly different between the groups (16+/-5.1% versus 16.8+/-7%, respectively). In addition, carotid IMT was significantly greater in subjects with lower serum bilirubin concentrations (0.5+/-0.13 mm versus 0.42+/-0.07 mm, p<0.0001). Furthermore, FMD in women with lower serum bilirubin concentrations was significantly lower than in women with higher serum bilirubin concentrations (11.5+/-4.9% and 17.5+/-4.7%, respectively, p<0.001). Accordingly, men with lower serum bilirubin concentrations had significantly lower FMD as compared to hyperbilirubinemic ones (11.7+/-3.6% versus 16.7+/-4.8%, respectively, p=0.009). Conversely, carotid IMT was significantly greater in both women and men with lower serum bilirubin concentrations compared to the subjects with elevated serum bilirubin concentrations (0.51+/-0.08 versus 0.41+/-0.08, p<0.001; 0.55+/-0.12 versus 0.40+/-0.07, p=0.002, in women and men, respectively).

CONCLUSION

The healthy subjects with lower serum bilirubin concentrations show significant ED and increased carotid IMT, which are predictors for atherosclerosis.

摘要

背景

低密度脂蛋白（LDL）胆固醇水平升高及其氧化修饰已被描述为参与动脉粥样硬化形成过程。胆红素作为一种抗氧化剂，可防止LDL的氧化修饰，因此可能预防动脉粥样硬化和冠心病（CHD）。肱动脉血流介导的舒张功能（FMD）受损，即内皮功能障碍（ED）和颈动脉内膜中层厚度（IMT）是动脉粥样硬化发生和进展的预测指标。在本研究中，对生理范围内血清胆红素浓度较低和较高的健康受试者进行了FMD和IMT研究。

方法

本研究纳入了91名年龄在25至45岁之间的健康受试者（47名血清胆红素浓度较低，44名血清胆红素浓度较高）。通过高分辨率血管超声测量颈动脉IMT和肱动脉血流介导的舒张功能。通过建立反应性充血来评估FMD，使用舌下含服硝酸异山梨酯测定内皮依赖性舒张功能（EID）。

结果

血清胆红素浓度较低的受试者的EDD明显比血清胆红素浓度较高的受试者差（分别为11.6±4.4%和7.2±4.7%，p<0.0001）。两组之间的EID测量值无显著差异（分别为16±5.1%和16.8±7%）。此外，血清胆红素浓度较低的受试者的颈动脉IMT明显更大（分别为0.5±0.13mm和0.42±0.07mm，p<0.0001）。此外，血清胆红素浓度较低的女性的FMD明显低于血清胆红素浓度较高的女性（分别为11.5±4.9%和17.5±4.7%，p<0.001）。相应地，血清胆红素浓度较低的男性的FMD明显低于高胆红素血症男性（分别为11.7±3.6%和16.7±4.8%，p=0.009）。相反，与血清胆红素浓度升高的受试者相比，血清胆红素浓度较低的女性和男性的颈动脉IMT均明显更大（女性分别为0.51±0.08和0.41±0.08，p<0.001；男性分别为0.55±0.12和