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Zhao P, Xu H, Shi Y, Song X, Qiu G, Ding C, Zhou W, Yu C, Wang T, Zhu L, Bao H, Cheng X. Association between bilirubin and chronic kidney disease in hypertensive patients: The China hypertension registry study. J Clin Hypertens (Greenwich) 2023; 25:1185-1192. [PMID: 37986685 PMCID: PMC10710547 DOI: 10.1111/jch.14727] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 11/22/2023]
Abstract
Limited data exists on the association between Direct bilirubin (DBIL) and Indirect bilirubin (IBIL) with the risk of chronic kidney disease (CKD) among patients with hypertension. This study aimed to assess the relationship between DBIL and IBIL with the risk of CKD in a cohort of Chinese adults diagnosed with hypertension. This study included 14 182 Chinese patients with hypertension between the ages of 27 and 96. CKD, the outcome variable, was defined by an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 . The study employed multivariate linear and multivariate logistic regression analysis to evaluate the correlation between DBIL and IBIL with the risk of CKD. The prevalence of CKD in the study population was 9.77%. Multivariate logistic regression analysis showed that the increase in DBIL (OR: 0.66; 95% CI: 0.61, 0.71) and IBIL (OR: 0.75; 95% CI: 0.71, 0.81) were independently and negatively correlated with CKD. Further analyses using a restricted cubic spline (smooth-fitting curve) confirmed the linearly negative association between DBIL and IBIL with the risk of CKD. The subgroup analysis showed that the correlation between IBIL and CKD was stronger among men and populations <65 years of age (p for interaction <.05). DBIL and IBIL were independently and negatively associated with CKD. Furthermore, the correlation between DBIL and IBIL with CKD in the hypertensive population is more significant in those under 65 years of age. These findings may inform future strategies for the management of CKD.
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Affiliation(s)
- Peixu Zhao
- Department of Cardiovascular Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
| | - Haitao Xu
- Rongcheng City Renhe Health CenterRongchengShandong ProvinceChina
| | - Yumeng Shi
- Department of Cardiovascular Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
| | - Xiaoli Song
- Department of Cardiovascular Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
| | - Guosheng Qiu
- Department of Cardiovascular Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
| | - Congcong Ding
- Department of Cardiovascular Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
| | - Wei Zhou
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
- Center for Prevention and Treatment of Cardiovascular Diseasesthe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Chao Yu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
- Center for Prevention and Treatment of Cardiovascular Diseasesthe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Tao Wang
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
- Center for Prevention and Treatment of Cardiovascular Diseasesthe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Lingjuan Zhu
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
- Center for Prevention and Treatment of Cardiovascular Diseasesthe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Huihui Bao
- Department of Cardiovascular Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
- Center for Prevention and Treatment of Cardiovascular Diseasesthe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
| | - Xiaoshu Cheng
- Department of Cardiovascular Medicinethe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
- Jiangxi Provincial Cardiovascular Disease Clinical Medical Research CenterNanchangJiangxiChina
- Jiangxi Sub‐center of National Clinical Research Center for Cardiovascular DiseasesNanChangJiangxiChina
- Center for Prevention and Treatment of Cardiovascular Diseasesthe Second Affiliated Hospital of Nanchang UniversityNanchangJiangxiChina
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Geng D, Wu B, Lin Y, Chen J, Tang W, Liu Y, He J. High total bilirubin-to-uric acid ratio predicts poor sleep quality after acute ischemic stroke: a prospective nested case-control study. Psychogeriatrics 2023; 23:897-907. [PMID: 37525331 DOI: 10.1111/psyg.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/11/2023] [Accepted: 05/29/2023] [Indexed: 08/02/2023]
Abstract
BACKGROUND Sleep disorders are prevalent after stroke, resulting in high recurrence rates and mortality. But the biomarkers of sleep disorders in stroke patients remain to be elucidated. This study aimed to explore the relationship between total bilirubin-to-uric acid ratio (TUR) and sleep quality after acute ischemic stroke (AIS). METHODS Three hundred twenty-six AIS patients were recruited and followed up 1 month after stroke in our study. Serum total bilirubin and uric acid levels were obtained within 24 h after admission. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality 1 month after stroke. We conducted receiver operating characteristic (ROC) curve analysis and screened the optimal biomarker to differentiate sleep disorders after stroke. Then the TUR was stratified according to the best cut-off value (0.036) of the ROC and further analysed by binary logistic regression analysis. Additionally, the interaction was used to explore the difference in its effect on post-stroke sleep quality in different subgroups. RESULTS Three hundred thirty-one patients (40.2%) were considered as having poor sleep quality during the one-month follow-up. Compared to patients with good sleep, patients with poor sleep were more likely to have higher TUR (IQR), 0.05 (0.03-0.06) versus 0.03 (0.02-0.04), P < 0.001. After adjusting for confounding factors, binary regression analysis demonstrated that a high TUR (≥0.036) was independently related to post-stroke poor sleep quality (OR = 3.75, 95% CI = 2.02-6.96, P < 0.001). CONCLUSIONS High TUR is associated with an increased risk of poor sleep quality in AIS patients, especially in females, diabetics, and patients with hyperlipidaemia.
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Affiliation(s)
- Dandan Geng
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Beilan Wu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yisi Lin
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiahao Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenjie Tang
- The First School of Clinical Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yuntao Liu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Li M, Li X, Liu Y, Liu X, Song Y, Zhao J, Mohan C, Wu T, Peng A, Qin L. Relationship between serum bilirubin levels s and the progression of renal function in patients with chronic kidney disease and hyperuricemia. Clin Chim Acta 2018; 486:156-161. [PMID: 30076802 DOI: 10.1016/j.cca.2018.07.045] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 07/12/2018] [Accepted: 07/30/2018] [Indexed: 12/11/2022]
Abstract
It is known that inflammation and oxidative stress have strong influences on chronic kidney disease (CKD). As an antioxidant, bilirubin is currently under extensive scrutiny. However, there are disagreements with regard to the oxidative and antioxidative roles of serum uric acid (SUA). This study aimed to investigate the relationship between serum bilirubin and the progression of renal function in CKD patients with hyperuricemia (HUA). This retrospective longitudinal study included 427 CKD patients. The endpoint was renal replacement therapy or death. Patients were divided into the following two groups according to the SUA level: HUA group (SUA ≥ 420 μmol/L for men; SUA ≥ 360 μmol/L for women) and normal uric acid level (NUA) group. A Cox proportional hazards model was used to evaluate the risk factors for renal outcomes in the two patient groups. The median follow-up time was 36 months. In the Cox regression analysis, the risk of renal outcomes in patients with serum indirect bilirubin (IBIL) levels >4.55 μmol/L was 0.15 times the risk in patients with serum IBIL levels ≤4.55 μmol/L (hazard ratio = 0.15, p = .013). Our findings suggest that a high serum IBIL level might be a protective factor for the progression of renal function in CKD patients with HUA.
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Affiliation(s)
- Mengyuan Li
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
| | - Xinhua Li
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
| | - Yan Liu
- Department of Nephrology, Heze Municipal Hospital, 2888, West Caozhou Road, Shandong 274031, China
| | - Xinying Liu
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
| | - Yaxiang Song
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
| | - Jian Zhao
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
| | - Chandra Mohan
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060, USA
| | - Tianfu Wu
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204-5060, USA
| | - Ai Peng
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China
| | - Ling Qin
- Department of Nephrology & Rheumatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301, Middle Yanchang Road, Shanghai 200072, China.
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