Kim Jonguk, Yoon Seung-Jae, Woo Min-Hee, Kim Sang-Heum, Kim Nam-Keun, Kim Jinkwon, Kim Ok-Joon, Oh Seung-Hun
Department of Neurology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
Department of Radiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
PLoS One. 2017 Mar 20;12(3):e0173736. doi: 10.1371/journal.pone.0173736. eCollection 2017.
A low serum total bilirubin (T-bil) level is associated with an increased risk of atherosclerosis. However, the differential impact of the serum T-bil level on cerebral atherosclerosis and cerebral small vessel disease (SVD) is still unclear.
We evaluated serum T-bil levels from 1,128 neurologically healthy subjects. Indices of cerebral atherosclerosis (extracranial arterial stenosis [ECAS] and intracranial arterial stenosis [ICAS]), and indices of SVD (silent lacunar infarct [SLI], and moderate-to-severe white matter hyperintensities [msWMH]) were evaluated by the use of brain magnetic resonance imaging (MRI) and MR angiography.
In logistic regression analysis after adjusting for confounding variables, subjects within middle T-bil (odds ratio [OR]: 0.63; 95% CI: 0.41-0.97) and high T-bil tertiles (OR: 0.54; 95% CI: 0.33-0.86) showed a lower prevalence of ECAS than those in a low T-bil tertile. Although subjects with a high T-bil tertile had a lower prevalence of ICAS than those with a low T-bil tertile, the statistical significance was marginal after adjusting for confounding variables. There were no significant differences in the proportions of subjects with SLI and msWMH across serum T-bil tertile groups.
The serum T-bil level is negatively associated with cerebral atherosclerosis, especially extracranial atherosclerosis, but not with SVD.
血清总胆红素（T-bil）水平较低与动脉粥样硬化风险增加相关。然而，血清T-bil水平对脑动脉粥样硬化和脑小血管疾病（SVD）的不同影响仍不清楚。
我们评估了1128名神经系统健康受试者的血清T-bil水平。通过脑磁共振成像（MRI）和磁共振血管造影评估脑动脉粥样硬化指标（颅外动脉狭窄[ECAS]和颅内动脉狭窄[ICAS]）以及SVD指标（无症状腔隙性梗死[SLI]和中度至重度白质高信号[msWMH]）。
在对混杂变量进行校正后的逻辑回归分析中，处于T-bil水平中等三分位数组（比值比[OR]：0.63；95%置信区间[CI]：0.41 - 0.97）和高T-bil三分位数组（OR：0.54；95% CI：0.33 - 0.86）的受试者，其ECAS患病率低于T-bil水平低三分位数组的受试者。虽然T-bil水平高三分位数组的受试者ICAS患病率低于T-bil水平低三分位数组的受试者，但在对混杂变量进行校正后，统计学意义不显著。血清T-bil三分位数组之间，SLI和msWMH受试者的比例没有显著差异。
血清T-bil水平与脑动脉粥样硬化，尤其是颅外动脉粥样硬化呈负相关，但与SVD无关。
