Zhu Cansheng, Xiong Zhaojun, Zheng Zhenda, Chen Yanming, Chen Xiaohong, Qian Xiaoxian
Department of Neurology, The Third Affiliated Hospital, Sun Yat-Sen University, China.
Intern Med. 2012;51(16):2083-9. doi: 10.2169/internalmedicine.51.7701. Epub 2012 Aug 15.
Elevated serum bilirubin concentrations protect from atherosclerotic diseases, however it is not clear whether or not higher serum bilirubin concentrations have the same effect in coronary artery disease (CAD). The brachial-ankle pulse wave velocity (baPWV) is a reproducible method to assess arterial stiffness. This study was aimed to investigate the relationship between serum total bilirubin (TB) and baPWV in patients with established CAD.
We enrolled 638 patients (390 men, 248 women) with established CAD. TB was divided into tertiles. Simple and multiple linear regression analyses were used to assess the correlation between baPWV and TB.
The mean baPWV tended to decrease in men according to TB tertiles: Tertile 1=2,126.0, Tertile 2=1,832.5, and Tertile 3=1,692.5 cm/s. Likewise, the mean baPWV tended to decrease in women according to TB tertiles: Tertile 1=1,920.8, Tertile 2=1,829.0, and Tertile 3=1,701.3 cm/s. Univariate analysis showed that age, BMI, TB, ALT, GGT, Cho, SBP, DBP, UA, and TC were significantly associated with baPWV in men. In women, age, BMI, current smoker, Cho, SBP, DBP, UA, TC, TG, HDL-C, and LDL-C were significantly associated with baPWV. BMI, LnSBP, UA, TB, LnCho, and LnTC were correlated with baPWV in men in the multivariate model. However, only LnSBP, UA, and LnHDL-C were correlated with baPWV in women. TB was found to be a significant determinant for decreased baPWV only in men (β=-0.136; p<0.001).
Our findings show that the level of total serum bilirubin is negatively correlated with arterial stiffness in men with established CAD.
血清胆红素浓度升高可预防动脉粥样硬化性疾病,但尚不清楚较高的血清胆红素浓度在冠状动脉疾病(CAD)中是否具有相同作用。肱踝脉搏波速度(baPWV)是一种评估动脉僵硬度的可重复方法。本研究旨在探讨已确诊CAD患者血清总胆红素(TB)与baPWV之间的关系。
我们纳入了638例已确诊CAD的患者(390例男性,248例女性)。将TB分为三分位数。采用简单和多元线性回归分析来评估baPWV与TB之间的相关性。
男性的平均baPWV随TB三分位数升高而呈下降趋势:第一三分位数=2126.0,第二三分位数=1832.5,第三三分位数=1692.5 cm/s。同样,女性的平均baPWV也随TB三分位数升高而呈下降趋势:第一三分位数=1920.8,第二三分位数=1829.0,第三三分位数=1701.3 cm/s。单因素分析显示,年龄、体重指数(BMI)、TB、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)、胆固醇(Cho)、收缩压(SBP)、舒张压(DBP)、尿酸(UA)和总胆固醇(TC)与男性的baPWV显著相关。在女性中,年龄、BMI、当前吸烟者、Cho、SBP、DBP、UA、TC、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)与baPWV显著相关。在多变量模型中,BMI、LnSBP、UA、TB、LnCho和LnTC与男性的baPWV相关。然而,在女性中,只有LnSBP、UA和LnHDL-C与baPWV相关。仅在男性中发现TB是baPWV降低的一个重要决定因素(β=-0.136;p<0.001)。
我们的研究结果表明,在已确诊CAD的男性中,血清总胆红素水平与动脉僵硬度呈负相关。