Oda Eiji
Medical Check-up Center, Tachikawa Medical Center, Nagachou 2-2-16, Nagaoka, Niigata 940-0053, Japan.
Atherosclerosis. 2014 Aug;235(2):334-8. doi: 10.1016/j.atherosclerosis.2014.05.927. Epub 2014 May 22.
To investigate cross-sectional and longitudinal associations between serum total bilirubin (TB) and LDL cholesterol.
It is a retrospective observational study. Cross-sectional and longitudinal associations between TB and hyper-LDL cholesterolemia were investigated in a health screening population. Odds ratios (ORs) of coexisting hyper-LDL cholesterolemia for TB were calculated in 3,866 subjects, Spearman's correlation coefficients between baseline TB and LDL cholesterol at baseline and after 4 years were calculated in 1,735 subjects who did not use antihyperlipidemic drugs and hazard ratios (HRs) of incident hyper-LDL cholesterolemia for TB were calculated in 1,992 followed subjects.
The ORs (p values) of coexisting hyper-LDL cholesterolemia for each 1 SD increase in TB was 1.04 (0.998) adjusted for sex, age, smoking, LDL cholesterol and other confounders. Spearman's correlation coefficients (p values) between baseline TB and LDL cholesterol at baseline and after 4 years and changes in LDL cholesterol were -0.026 (0.271), -0.078 (0.001) and -0.062 (0.010), respectively. Among 1,992 followed subjects, 481 developed hyper-LDL cholesterolemia during 4 years (60.4 per 1,000 person-years). The HRs (95% confidence intervals; p values) of incident hyper-LDL cholesterolemia for each 1 SD increase in TB was 0.86 (0.77-0.96; 0.006) adjusted for sex, age, smoking, LDL cholesterol, body mass index, triglycerides, HDL cholesterol, fasting glucose and other confounders. The quintiles of TB were significantly associated with the incident hyper-LDL cholesterolemia adjusted for the above covariates (p for trend = 0.008).
A decrease in TB predicted incident hyper-LDL cholesterolemia in a health screening population.
研究血清总胆红素（TB）与低密度脂蛋白胆固醇之间的横断面及纵向关联。
这是一项回顾性观察研究。在健康筛查人群中研究TB与高LDL胆固醇血症之间的横断面及纵向关联。计算了3866名受试者中TB并存高LDL胆固醇血症的比值比（OR），计算了1735名未使用抗血脂药物受试者基线时TB与LDL胆固醇之间以及4年后的Spearman相关系数，并计算了1992名随访受试者中TB引发高LDL胆固醇血症的风险比（HR）。
在校正性别、年龄、吸烟、LDL胆固醇及其他混杂因素后，TB每增加1个标准差，并存高LDL胆固醇血症的OR（p值）为1.04（0.998）。基线时TB与LDL胆固醇之间、4年后TB与LDL胆固醇之间以及LDL胆固醇变化的Spearman相关系数（p值）分别为-0.026（0.271）、-0.078（0.001）和-0.062（0.010）。在1992名随访受试者中，481人在4年内发生了高LDL胆固醇血症（每1000人年60.4例）。在校正性别、年龄、吸烟、LDL胆固醇、体重指数、甘油三酯、HDL胆固醇、空腹血糖及其他混杂因素后，TB每增加1个标准差，发生高LDL胆固醇血症的HR（95%置信区间；p值）为0.86（0.77 - 0.96；0.006）。TB五分位数与校正上述协变量后的高LDL胆固醇血症发生率显著相关（趋势p = 0.008）。
在健康筛查人群中，TB降低预示着高LDL胆固醇血症的发生。
