Department of Internal Medicine, Healthcare Research Institute, Seoul National University, Hospital Healthcare System Gangnam Center, Seoul, South Korea.
Atherosclerosis. 2013 Oct;230(2):242-8. doi: 10.1016/j.atherosclerosis.2013.06.021. Epub 2013 Jul 20.
Inverse correlations of high serum bilirubin with metabolic and cardiovascular disease have been suggested. However, anti-atherogenic effects of bilirubin have not been well-established in terms of the presence of plaques and stenosis identified in coronary computed tomography (CT).
A cross-sectional study was conducted on 2862 men who were free of cardiovascular disease and underwent coronary CT as part of a routine medical screening examination. Coronary stenotic lesions were considered to be incidences of coronary atherosclerosis, and stenosis was classified as stenosis <50% or ≥50%, according to degree of stenosis.
The prevalences of coronary atherosclerosis and stenosis ≥50% in subjects with elevated bilirubin levels (>1.2 mg/dL) were lower than those in subjects with normal bilirubin levels (≤1.2 mg/dL) (19.9% vs. 27.9%, p < 0.001, 8.5% vs. 10.3%, p = 0.044). Bilirubin was inversely associated with total plaques (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.48-0.73 in the 4th quartile vs. 1st quartile) and calcified plaques (OR 0.60, 95% CI 0.49-0.75) in univariate analysis. After adjusting for traditional risk factors, it was found that coronary atherosclerosis (OR 0.73, 95% CI 0.56-0.94 in the 4th quartile vs. 1st quartile) and calcified plaque (OR 0.66, 95% CI 0.53-0.84) were inversely associated with the bilirubin grade in a dose-dependent manner.
The serum bilirubin level was inversely associated with coronary atherosclerosis and calcified plaques in a dose-dependent manner. These results suggested that serum bilirubin could be used as a protective biomarker of coronary artery disease.
高血清胆红素与代谢和心血管疾病呈负相关关系已被提出。然而，胆红素的抗动脉粥样硬化作用在冠状动脉计算机断层扫描（CT）中发现的斑块和狭窄方面尚未得到充分证实。
对 2862 名无心血管疾病且接受冠状动脉 CT 作为常规医疗筛查检查一部分的男性进行了一项横断面研究。冠状动脉狭窄病变被认为是冠状动脉粥样硬化的发生率，根据狭窄程度将狭窄分为<50%或≥50%。
胆红素水平升高（>1.2mg/dL）患者的冠状动脉粥样硬化和狭窄≥50%的患病率低于胆红素水平正常（≤1.2mg/dL）的患者（19.9%比 27.9%，p<0.001，8.5%比 10.3%，p=0.044）。胆红素与总斑块（比值比[OR]0.59，四分位距[IQR]第 4 四分位距与第 1 四分位距的 95%置信区间[CI]0.48-0.73）和钙化斑块（OR 0.60，95%CI0.49-0.75）呈负相关在单因素分析中。在调整了传统危险因素后，发现冠状动脉粥样硬化（OR0.73，四分位距第 4 四分位距与第 1 四分位距的 95%CI0.56-0.94）和钙化斑块（OR0.66，95%CI0.53-0.84）与胆红素水平呈剂量依赖性负相关。
血清胆红素水平与冠状动脉粥样硬化和钙化斑块呈剂量依赖性负相关。这些结果表明，血清胆红素可作为冠状动脉疾病的保护性生物标志物。
