Liu Chunjiang, Li Kuan, Wang Guohua, He Ziqian, Cao Suyan
Department of General Surgery, Shaoxing People's Hospital (The First Affiliated Hospital, Shaoxing University), No. 568 Zhong Xing Road, Shaoxing, Zhejiang, China.
Department of Hepatobiliary Surgery, Kunshan Hospital of Traditional Chinese Medicine, No. 388 Zuchongzhi Road, Kunshan, Jiangsu, China.
Mediators Inflamm. 2025 Jul 27;2025:5229580. doi: 10.1155/mi/5229580. eCollection 2025.
The purpose of our study was to examine the association between serum total bilirubin level and abdominal aortic calcification (AAC) in the general United States population. We analyzed data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) to assess the association of total bilirubin levels with AAC and severe AAC (SAAC). Restricted cubic spline (RCS) plots, weighted multivariable logistic regression (odds ratios [ORs] and 95% confidence intervals [CIs]), and stratified subgroup analyses (by age, sex, hypertension, diabetes mellitus, and body mass index [BMI]) were conducted. Our analysis included a total of 3016 participants. First, the RCS plots showed the U-shaped curve association of serum total bilirubin level with prevalence of AAC and SAAC. RCS analysis revealed a U-shaped association between serum total bilirubin levels and the prevalence of both AAC and SAAC. Serum total bilirubin levels were categorized into quartiles: Q1 (0.10-0.50 mg/dL), Q2 (0.51-0.60 mg/dL), Q3 (0.61-0.80 mg/dL), and Q4 (0.81-2.20 mg/dL). Second, after adjusting for potential confounders, compared with the Q1 group, the ORs with 95% CI for the association of total bilirubin level with AAC and SAAC across Q2, Q3, and Q4 were (0.71 (0.61, 0.98), 1.11 (0.90, 1.38), and 1.36 (1.07, 1.73) and 0.78 (0.58, 1.21), 1.12 (0.77, 1.65), and 1.28 (0.87, 1.77)), respectively. Finally, this U-shaped correlation was found among participants in age ≥60 years, with hypertension, with DM and with BMI of ≥30 kg/m. Our study identified a significant U-shaped association between serum total bilirubin levels and both AAC and SAAC. These findings suggested that monitoring and optimizing total bilirubin levels may offer potential preventive benefits against AAC development.
我们研究的目的是在美国普通人群中检验血清总胆红素水平与腹主动脉钙化（AAC）之间的关联。我们分析了2013 - 2014年国家健康与营养检查调查（NHANES）的数据，以评估总胆红素水平与AAC及严重腹主动脉钙化（SAAC）之间的关联。进行了受限立方样条（RCS）图分析、加权多变量逻辑回归（比值比[ORs]和95%置信区间[CIs]）以及分层亚组分析（按年龄、性别、高血压、糖尿病和体重指数[BMI]）。我们的分析共纳入3016名参与者。首先，RCS图显示血清总胆红素水平与AAC及SAAC患病率呈U形曲线关联。RCS分析揭示血清总胆红素水平与AAC和SAAC的患病率之间均呈U形关联。血清总胆红素水平被分为四分位数：Q1（0.10 - 0.50mg/dL）、Q2（0.51 - 0.60mg/dL）、Q3（0.61 - 0.80mg/dL）和Q4（0.81 - 2.20mg/dL）。其次，在调整潜在混杂因素后，与Q1组相比，总胆红素水平与AAC及SAAC关联的Q2、Q3和Q4组的ORs及95%CI分别为（0.71（0.61，0.98）、1.11（0.90，1.38）和1.36（1.07，1.73））以及（0.78（0.58，1.21）、1.12（0.77，1.65）和1.28（0.87，1.77））。最后，在年龄≥60岁、患有高血压、患有糖尿病且BMI≥30kg/m²的参与者中发现了这种U形相关性。我们的研究确定血清总胆红素水平与AAC和SAAC之间存在显著的U形关联。这些发现表明监测和优化总胆红素水平可能对预防AAC发展具有潜在益处。
