State Key Laboratory of Molecular Vaccinology and Molecular Diagnotics, School of Public Health, Xiamen University, No. 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, 361102, Fujian, People's Republic of China.
Xiamen Guankou Hospital, No. 270 Jingshan Road, Jimei District, Xiamen, 361023, Fujian, People's Republic of China.
J Transl Med. 2022 Mar 4;20(1):108. doi: 10.1186/s12967-022-03309-7.
Hypertension is highly prevalent and associated with the elevated risks of cardiovascular diseases, dementia, and physical disabilities among adults. Although the correlation between bilirubin and hypertension has been reported, the observation in quinquagenarian population is scarce. We aimed to examine bilirubin-hypertension association in Guankou Ageing Cohort Study.
Participants ≥ 55 years were recruited and their questionnaires and physical examination data were collected. Kaplan-Meier survival analysis and Cox proportional hazards regression were implemented to assess the hypertension risk. The non-liner dose-response relationships of bilirubin-hypertension were determined by restricted cubic spline (RCS) models. Receiver operating characteristic (ROC) curves and multiple factors analysis (MFA) were performed to evaluate the predictive abilities.
1881 eligible participants (male 43.75%, female 56.25%) with the median age of 61.00 (59.00-66.00) were included. The hazard ratio (HR, 95% CI) of serum total bilirubin (STB) and unconjugated bilirubin (UCB) were 1.03 (1.01-1.05) and 1.05 (1.03-1.07), while conjugated bilirubin (CB) showed a weak protective effect with the HR of 0.96 (0.92-0.99), and the associations remained significant in all models. RCS analyses further indicated the similar bidirectional effects of STB and UCB with the cut-off of 12.17 μmol/L and 8.59 μmol/L, while CB exhibited inverse bidirectional dose-response relationship with a cut-off of 3.47 μmol/L. ROC curves and MFA showed baseline STB combined with age, BMI, and waist circumference could well discriminate the low and high of hypertension risk.
Our findings suggested the higher levels of total and unconjugated bilirubin were hazardous factors of hypertension, while an inverse effect presented when more bilirubin was conjugated.
高血压在成年人中发病率较高，与心血管疾病、痴呆和身体残疾的风险升高有关。虽然已经报道了胆红素与高血压之间的相关性，但在 55 岁以上人群中的观察结果还很有限。本研究旨在探讨关门口老龄化队列研究中胆红素与高血压之间的关系。
招募年龄≥55 岁的参与者，并收集他们的问卷和体检数据。采用 Kaplan-Meier 生存分析和 Cox 比例风险回归评估高血压风险。采用限制性立方样条（RCS）模型确定胆红素与高血压之间的非线性剂量-反应关系。通过受试者工作特征（ROC）曲线和多因素分析（MFA）评估预测能力。
共纳入 1881 名符合条件的参与者（男性 43.75%，女性 56.25%），中位年龄为 61.00（59.00-66.00）岁。血清总胆红素（STB）和未结合胆红素（UCB）的危险比（HR，95%CI）分别为 1.03（1.01-1.05）和 1.05（1.03-1.07），而结合胆红素（CB）则表现出较弱的保护作用，HR 为 0.96（0.92-0.99），所有模型的结果均具有统计学意义。RCS 分析进一步表明，STB 和 UCB 呈相似的双向作用，其截断值分别为 12.17μmol/L 和 8.59μmol/L，而 CB 则表现出与截断值为 3.47μmol/L 的反向双向剂量反应关系。ROC 曲线和 MFA 显示，基线 STB 与年龄、BMI 和腰围相结合，能够很好地区分高血压风险的高低。
本研究结果表明，总胆红素和未结合胆红素水平升高是高血压的危险因素，而胆红素结合程度增加则呈现出相反的效果。
