Yesilova Zeki, Serdar Muhittin, Ercin C Nuri, Gunay Alp, Kilciler Guldem, Hasimi Adnan, Uygun Ahmet, Kurt Ismail, Erbil M Kemal, Dagalp Kemal
Department of Gastroenterology, Gülhane Millitary Medical School, Ankara, Turkey.
J Gastroenterol Hepatol. 2008 Oct;23(10):1556-60. doi: 10.1111/j.1440-1746.2008.05388.x. Epub 2008 Jun 3.
The association of hyperbilirubinemia in Gilbert's syndrome (GS) with a decrease in prevalence of coronary artery disease is a well-known phenomenon. In this study, the state of low-density lipoprotein (LDL) oxidation which has been postulated to be a significant determinant at the etiopathogenesis of atherosclerotic disorders was investigated among individuals with GS.
For this purpose, serum cholesterol, LDL cholesterol, high-density lipoprotein cholesterol, triglycerides, uric acid, apolipoprotein A and B, bilirubins, thiobarbituric acid-reactive substances, and the sensitivity of LDL oxidation levels, as well as serum alanine aminotransferase, aspartate aminotranserfase, gamma glutamyl transferase, and alkaline phosphatase activities, were determined in 17 patients with Gilbert's syndrome and 15 healthy adults.
There was no significant difference between the groups except the indirect bilirubin parameter (P < 0.001). In comparison with the healthy individuals, LDL oxidation levels between 75 and 120 min were significantly lower (P < 0.005) along with prolonged lag-phase in GS patients, indicating a delay in oxidation susceptibility.
It is suggested that the chronic hyperbilirubinemia leading to a lag-phase prolongation in LDL oxidation and a decrease in LDL oxidation may be reason for the low percentage of coronary artery disease.
吉尔伯特综合征(GS)中的高胆红素血症与冠状动脉疾病患病率降低之间的关联是一个众所周知的现象。在本研究中,对GS患者中低密度脂蛋白(LDL)氧化状态进行了调查,LDL氧化被认为是动脉粥样硬化疾病发病机制中的一个重要决定因素。
为此,测定了17例吉尔伯特综合征患者和15名健康成年人的血清胆固醇、LDL胆固醇、高密度脂蛋白胆固醇、甘油三酯、尿酸、载脂蛋白A和B、胆红素、硫代巴比妥酸反应性物质、LDL氧化水平的敏感性,以及血清丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转移酶和碱性磷酸酶活性。
除间接胆红素参数外,两组之间无显著差异(P<0.001)。与健康个体相比,GS患者在75至120分钟之间的LDL氧化水平显著降低(P<0.005),同时滞后期延长,表明氧化敏感性延迟。
提示慢性高胆红素血症导致LDL氧化滞后期延长和LDL氧化降低可能是冠状动脉疾病发生率低的原因。