Ho Yang, Chen Tzen-Wen, Huang Tung-Po, Chen Ying-Hwa, Tarng Der-Cherng
Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan.
Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan.
Antioxidants (Basel). 2021 Aug 31;10(9):1403. doi: 10.3390/antiox10091403.
Serum bilirubin levels, which are determined by a complex interplay of various enzymes, including heme oxygenase-1 (HO-1) and uridine diphosphate-glucuronosyl transferase (UGT1A1), may be protective against progression of cardiovascular disease (CVD) in hemodialysis patients. However, the combined effect of and gene polymorphisms on CVD outcomes among hemodialysis patients is still unknown. This retrospective study enrolled 1080 prevalent hemodialysis patients and the combined genetic polymorphisms of and on serum bilirubin were analyzed. Endpoints were CVD events and all-cause mortality. Mean serum bilirubin was highest in patients with S/S + S/L of the promoter and 7/7 genotypes (Group 1), intermediate in those with S/S + S/L of the promoter and 7/6 + 6/6 genotypes (Group 2), and lowest in the carriers with the L/L promoter and 7/6 + 6/6 genotypes (Group 3) ( < 0.001). During a median follow-up of 50 months, 433 patients developed CVD. Compared with patients in Group 3, individuals among Groups 1 and 2 had significantly lower risks for CVD events (adjusted hazard ratios (aHRs) of 0.35 for Group 1 and 0.63 for Group 2), respectively. Compared with the lower bilirubin tertile, the aHRs were 0.72 for the middle tertile and 0.40 for the upper tertile for CVD events. We summarized that serum bilirubin as well as and gene polymorphisms were associated with CVD among patients receiving chronic hemodialysis.
血清胆红素水平由包括血红素加氧酶 -1（HO -1）和尿苷二磷酸 - 葡萄糖醛酸基转移酶（UGT1A1）在内的多种酶的复杂相互作用所决定，可能对血液透析患者心血管疾病（CVD）的进展具有保护作用。然而，[此处原文缺失两个基因名称]基因多态性对血液透析患者CVD结局的联合影响仍不清楚。这项回顾性研究纳入了1080例维持性血液透析患者，并分析了[此处原文缺失两个基因名称]基因多态性与血清胆红素的联合情况。终点指标为CVD事件和全因死亡率。[此处原文缺失一个基因名称]启动子S/S + S/L以及[此处原文缺失一个基因名称]7/7基因型的患者血清胆红素均值最高（第1组），[此处原文缺失一个基因名称]启动子S/S + S/L以及[此处原文缺失一个基因名称]7/6 + 6/6基因型的患者血清胆红素均值处于中间水平（第2组），而[此处原文缺失一个基因名称]启动子L/L以及[此处原文缺失一个基因名称]7/6 + 6/6基因型的携带者血清胆红素均值最低（第3组）（P < 0.001）。在中位随访50个月期间，433例患者发生了CVD。与第3组患者相比，第1组和第2组个体发生CVD事件的风险显著更低（第1组调整后风险比（aHRs）为0.35，第2组为0.63）。与胆红素水平较低的三分位数相比，CVD事件的aHRs在中间三分位数为0.72，在上三分位数为0.40。我们总结认为，血清胆红素以及[此处原文缺失两个基因名称]基因多态性与接受慢性血液透析患者的CVD有关。
