Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Beijing, China.
Curr Neurovasc Res. 2019;16(2):148-155. doi: 10.2174/1567202616666190412153735.
Bilirubin has been recognized as a potential endogenous inhibitor of atherosclerosis, being inversely associated with carotid intima-media thickness (CIMT). However, little information is available concerning the correlation between serum indirect bilirubin (IBIL), especially long-term IBIL level, and early atherosclerosis progression. This study was designed to evaluate the relationship between serum IBIL level and CIMT progression.
A total of 2205 participants were enrolled in this Asymptomatic Polyvascular Abnormalities Community study (APAC study). CIMT was measured at baseline and 2-year follow-up. The participants were divided into four groups based on their serum IBIL levels at baseline. Both baseline and average serum IBIL values during the 2-year follow up were used in the analysis. Multivariable logistic regression and linear regression were used to assess the associations between serum IBIL and CIMT progression.
The results showed that 51.93% (1145/2205) of participants were diagnosed with CIMT progression during the 2-year follow-up. Baseline serum IBIL level was significantly associated with the incidence of CIMT progression after adjusting for other potential confounding factors. Compared with the first quartile, adjusted odds ratios (OR) of the second, third, and fourth quartiles of IBIL were 0.70 [95% confidence interval (CI), 0.55-0.90], 0.68 (95% CI, 0.52-0.87), and 0.63 (95% CI, 0.49-0.82) (P = 0.0006), respectively. Serum IBIL level during the follow-up was also associated with CIMT progression in the univariate analysis (P = 0.0022), although no longer significant after adjusting for potential confounders in the multiple linear regression.
The study demonstrated the inverse relationship between serum IBIL and CIMT progression. Lower serum IBIL level is an independent predictor of subclinical atherosclerosis.
胆红素已被认为是动脉粥样硬化的潜在内源性抑制剂，与颈动脉内膜中层厚度（CIMT）呈负相关。然而，关于血清间接胆红素（IBIL），尤其是长期 IBIL 水平与早期动脉粥样硬化进展之间的相关性，信息较少。本研究旨在评估血清 IBIL 水平与 CIMT 进展之间的关系。
共有 2205 名参与者参加了这项无症状多血管异常社区研究（APAC 研究）。在基线和 2 年随访时测量 CIMT。根据基线时的血清 IBIL 水平，将参与者分为四组。分析中同时使用了基线和 2 年随访期间的平均血清 IBIL 值。采用多变量逻辑回归和线性回归来评估血清 IBIL 与 CIMT 进展之间的关系。
结果显示，在 2 年的随访期间，51.93%（1145/2205）的参与者被诊断为 CIMT 进展。在校正其他潜在混杂因素后，基线血清 IBIL 水平与 CIMT 进展的发生率显著相关。与第一四分位相比，IBIL 的第二、第三和第四四分位的校正优势比（OR）分别为 0.70[95%置信区间（CI），0.55-0.90]、0.68（95%CI，0.52-0.87）和 0.63（95%CI，0.49-0.82）（P=0.0006）。在单变量分析中，随访期间的血清 IBIL 水平也与 CIMT 进展相关（P=0.0022），尽管在多元线性回归中校正潜在混杂因素后不再显著。
该研究表明，血清 IBIL 与 CIMT 进展呈负相关。较低的血清 IBIL 水平是亚临床动脉粥样硬化的独立预测因子。
