Hughes J T, Barzi F, Hoy W E, Jones G R D, Rathnayake G, Majoni S W, Thomas M A B, Sinha A, Cass A, MacIsaac R J, O'Dea K, Maple-Brown L J
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia; Department of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia.
Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Clin Biochem. 2017 Dec;50(18):1040-1047. doi: 10.1016/j.clinbiochem.2017.08.011. Epub 2017 Aug 20.
Low serum bilirubin concentrations are reported to be strongly associated with cardio-metabolic disease, but this relationship has not been reported among Indigenous Australian people who are known to be at high risk for diabetes and chronic kidney disease (CKD).
serum bilirubin will be negatively associated with markers of chronic disease, including CKD and anaemia among Indigenous Australians.
A cross-sectional analysis of 594 adult Aboriginal and Torres Strait Islander (TSI) people in good health or with diabetes and markers of CKD. Measures included urine albumin: creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), haemoglobin (Hb) and glycated haemoglobin (HbA1c). Diabetes was defined by medical history, medications or HbA1c≥6.5% or ≥48mmol/mol. Anaemia was defined as Hb<130g/L or <120g/L in males and females respectively. A multivariate regression analysis examining factors independently associated with log-bilirubin was performed.
Participants mean (SD) age was 45.1 (14.5) years, and included 62.5% females, 71.7% Aboriginal, 41.1% with diabetes, 16.7% with anaemia, 41% with ACR>3mg/mmol and 18.2% with eGFR<60mL/min/1.73m. Median bilirubin concentration was lower in females than males (6 v 8μmol/L, p<0.001) and in Aboriginal than TSI participants (6 v 9.5μmol/L, p<0.001). Six factors explained 35% of the variance of log-bilirubin; Hb and cholesterol (both positively related) and ACR, triglycerides, Aboriginal ethnicity and female gender (all inversely related).
Serum bilirubin concentrations were positively associated with Hb and total cholesterol, and inversely associated with ACR. Further research to determine reasons explaining lower bilirubin concentrations among Aboriginal compared with TSI participants are needed.
据报道，低血清胆红素浓度与心血管代谢疾病密切相关，但在已知患糖尿病和慢性肾病（CKD）风险较高的澳大利亚原住民中，这种关系尚未见报道。
血清胆红素与慢性病标志物呈负相关，包括澳大利亚原住民中的CKD和贫血。
对594名健康或患有糖尿病及CKD标志物的成年原住民和托雷斯海峡岛民（TSI）进行横断面分析。测量指标包括尿白蛋白：肌酐比值（ACR）、估算肾小球滤过率（eGFR）、血红蛋白（Hb）和糖化血红蛋白（HbA1c）。糖尿病根据病史、用药情况或HbA1c≥6.5%或≥48mmol/mol定义。贫血分别定义为男性Hb<130g/L或女性Hb<120g/L。进行多变量回归分析，以检验与对数胆红素独立相关的因素。
参与者的平均（标准差）年龄为45.1（14.5）岁，其中女性占62.5%，原住民占71.7%，糖尿病患者占41.1%，贫血患者占16.7%，ACR>3mg/mmol者占41%，eGFR<60mL/min/1.73m者占18.2%。女性的胆红素中位数浓度低于男性（6对8μmol/L，p<0.001），原住民参与者低于TSI参与者（6对9.5μmol/L，p<0.001）。六个因素解释了对数胆红素变异的35%；Hb和胆固醇（均呈正相关）以及ACR、甘油三酯、原住民种族和女性性别（均呈负相关）。
血清胆红素浓度与Hb和总胆固醇呈正相关，与ACR呈负相关。需要进一步研究以确定澳大利亚原住民参与者胆红素浓度低于TSI参与者的原因。
