Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
Institute of Clinical Medicine, National Yang-Ming University, Taipei 11217, Taiwan.
Int J Mol Sci. 2018 Dec 29;20(1):117. doi: 10.3390/ijms20010117.
Bilirubin is a well-known neurotoxin in newborn infants; however, current evidence has shown that a higher serum bilirubin concentration in physiological ranges is associated with a lower risk for the development and progression of both chronic kidney disease (CKD) and cardiovascular disease (CVD) in adults. The protective mechanisms of bilirubin in CVD, CKD, and associated mortality may be ascribed to its antioxidant and anti-inflammatory properties. Bilirubin further improves insulin sensitivity, reduces low-density lipoprotein cholesterol levels and inhibits platelet activation in at-risk individuals. These effects are expected to maintain normal vascular homeostasis and thus reduce the incidence of CKD and the risks of cardiovascular complications and death. In this review, we highlight the recent advances in the biological actions of bilirubin in the pathogenesis of CVD and CKD progression, and further propose that targeting bilirubin metabolism could be a potential approach to ameliorate morbidity and mortality in CKD patients.
胆红素是新生儿中众所周知的神经毒素；然而，现有证据表明，生理范围内较高的血清胆红素浓度与成年人慢性肾脏病 (CKD) 和心血管疾病 (CVD) 的发展和进展风险降低相关。胆红素在 CVD、CKD 和相关死亡率中的保护机制可能归因于其抗氧化和抗炎特性。胆红素进一步提高胰岛素敏感性，降低高危个体的低密度脂蛋白胆固醇水平并抑制血小板激活。这些作用有望维持正常的血管内稳态，从而降低 CKD 的发病率以及心血管并发症和死亡的风险。在这篇综述中，我们强调了胆红素在 CVD 和 CKD 进展发病机制中的生物学作用的最新进展，并进一步提出靶向胆红素代谢可能是改善 CKD 患者发病率和死亡率的潜在方法。
