El-Eshmawy Mervat M, Mahsoub Nancy, Elsehely Ibrahim
Internal Medicine Department, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Porto Biomed J. 2024 Nov 19;9(6):274. doi: 10.1097/j.pbj.0000000000000275. eCollection 2024 Nov-Dec.
BACKGROUND/AIM: The link between serum total bilirubin and metabolic syndrome and its components has been previously proposed. However, it is unknown whether total bilirubin is a risk factor of metabolic syndrome and its components in obese Egyptians. Therefore, this study was conducted to clarify the association of total bilirubin levels with metabolic syndrome and its components in obese Egyptians.
A total of 200 adults with obesity were enrolled in this study. Obese participants were evaluated for metabolic syndrome; there were 92 obese participants with metabolic syndrome and 108 obese participants without metabolic syndrome. Anthropometric measurements, fasting blood glucose (FBG), fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), HOMA-β (%), lipid profile, uric acid, alanine aminotransferase, aspartate aminotransferase, and serum total bilirubin were assessed.
Total bilirubin was significantly lower in obese participants with metabolic syndrome than in those without metabolic syndrome. Compared with middle bilirubin tertile, high and low bilirubin tertiles were independently associated with metabolic syndrome. Regarding metabolic syndrome components, a significant positive association between low bilirubin tertile and hypertension was found independent of the all studied confounding factors, whereas the association of total bilirubin level with waist circumference (WC), FBG, high-density lipoprotein cholesterol, and triglycerides was dependent on body mass index (BMI), HOMA-IR, and high sensitive C-reactive protein (hs-CRP).
Total bilirubin is an independent risk factor of metabolic syndrome in obese Egyptians. We have found an independent association between high bilirubin level and reduced risk of metabolic syndrome, whereas low bilirubin level was associated with increased risk of metabolic syndrome. Bilirubin is also independently associated with hypertension, but its association with other components of metabolic syndrome is mainly dependent on BMI, HOMA-IR, and hs-CRP.
背景/目的：血清总胆红素与代谢综合征及其组分之间的联系此前已被提出。然而，在肥胖的埃及人中，总胆红素是否为代谢综合征及其组分的危险因素尚不清楚。因此，本研究旨在阐明肥胖埃及人中总胆红素水平与代谢综合征及其组分之间的关联。
本研究共纳入200名肥胖成年人。对肥胖参与者进行代谢综合征评估；其中92名肥胖参与者患有代谢综合征，108名肥胖参与者未患代谢综合征。评估了人体测量指标、空腹血糖（FBG）、空腹胰岛素、胰岛素抵抗稳态模型评估（HOMA-IR）、HOMA-β（%）、血脂谱、尿酸、丙氨酸转氨酶、天冬氨酸转氨酶和血清总胆红素。
患有代谢综合征的肥胖参与者的总胆红素显著低于未患代谢综合征的参与者。与胆红素三分位数处于中间水平相比，胆红素三分位数处于高、低水平与代谢综合征独立相关。关于代谢综合征组分，发现胆红素三分位数处于低水平与高血压之间存在显著正相关，且独立于所有研究的混杂因素，而总胆红素水平与腰围（WC）、FBG、高密度脂蛋白胆固醇和甘油三酯之间的关联取决于体重指数（BMI）、HOMA-IR和高敏C反应蛋白（hs-CRP）。
总胆红素是肥胖埃及人代谢综合征的独立危险因素。我们发现高胆红素水平与代谢综合征风险降低之间存在独立关联，而低胆红素水平与代谢综合征风险增加相关。胆红素还与高血压独立相关，但其与代谢综合征其他组分的关联主要取决于BMI、HOMA-IR和hs-CRP。
