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Hertiš Petek T, Marčun Varda N. Childhood Cardiovascular Health, Obesity, and Some Related Disorders: Insights into Chronic Inflammation and Oxidative Stress. Int J Mol Sci 2024; 25:9706. [PMID: 39273654 PMCID: PMC11396019 DOI: 10.3390/ijms25179706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 09/01/2024] [Accepted: 09/03/2024] [Indexed: 09/15/2024] Open
Abstract
Childhood obesity and associated metabolic abnormalities have become pressing public health concerns worldwide, significantly impacting cardiovascular health. Metabolic syndrome, characterized by a cluster of metabolic abnormalities including central obesity, altered glucose metabolism, dyslipidemia, and arterial hypertension, has emerged as a critical precursor to cardiovascular disease. Chronic systemic inflammation and oxidative stress seem to play pivotal roles in the pathogenesis of childhood obesity-related disorders such as early atherosclerosis. A significant distinction between the objective components of cardiovascular health metrics, including body mass index, blood pressure, cholesterol, and fasting glucose levels, and the definition of metabolic syndrome is evident in the identification of obesity. Whereas cardiovascular health metrics predominantly rely on body mass index percentiles to assess obesity, metabolic syndrome criteria prioritize waist circumference, specifically targeting individuals with a measurement ≥90th percentile. This discrepancy emphasizes the need for a nuanced approach in assessing the risks associated with obesity and underscores the importance of considering multiple factors when evaluating cardiovascular risk in children. By recognizing the complex interplay between various health metrics, obesity and metabolic syndrome criteria, clinicians can more accurately identify individuals at risk and tailor interventions accordingly to mitigate cardiovascular disease in children with obesity.
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Affiliation(s)
- Tjaša Hertiš Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
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Xu W, Wu J, Chen D, Zhang R, Yang Y. Causal validation of the relationship between 35 blood and urine biomarkers and hyperthyroidism: a bidirectional Mendelian randomization study and meta-analysis. Front Endocrinol (Lausanne) 2024; 15:1430798. [PMID: 39188917 PMCID: PMC11345139 DOI: 10.3389/fendo.2024.1430798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/23/2024] [Indexed: 08/28/2024] Open
Abstract
Background Hyperthyroidism is an endocrine disorder with a relatively low global prevalence but significantly higher incidence among females compared to males. The onset age primarily ranges from 30 to 50, although it is not limited to this age group. Challenges in the treatment of hyperthyroidism include individualized treatment plan formulation, management of side effects, and prediction of disease progression, necessitating comprehensive consideration to achieve more effective therapy and management. Mendelian randomization studies can reveal more precise therapeutic targets between blood and urine biomarkers and hyperthyroidism, providing more decadent treatment options for the condition. Methods The study will build upon the omics Mendelian randomization (MR) framework by conducting MR analysis using 35 blood and urine biomarkers separately for two distinct databases of hyperthyroidism. Subsequently, the results will undergo meta-analysis and multiple corrections to ensure accuracy and reliability. Finally, positive findings will undergo reverse MR validation to verify causal relationships with hyperthyroidism. Results In the British database, the MR analysis of Total bilirubin levels about hyperthyroidism yielded an odds ratio (OR) of 1.097 (95% CI: 0.951-1.265, P = 0.205). Conversely, in the Thyroid Omics Association database, the MR analysis revealed an OR of 1.283 (95% CI: 1.122-1.467, P = 0.0002) for the same relationship. Meta-analysis of the MR analysis results from both databases, following multiple corrections, resulted in an OR of 1.192 (95% CI: 1.081-1.314, P = 0.015). Additionally, the direction of beta values in the MR analysis results from both databases was consistent. Conclusion The urine biomarker total bilirubin levels may contribute to an increased risk of hyperthyroidism and accelerate its progression, thus representing a risk factor for the condition.
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Affiliation(s)
| | | | | | | | - Yue Yang
- Department of Breast and Thyroid Surgery, First People’s Hospital of Kunming City & Calmette Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
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Aslantas M, Kilicaslan O, Eröz R, Kocabay K. The Evaluation of the Genetic Variation Types of the Uridine Diphosphate Glucuronosyl Transferase 1A1 Gene by Next-Generation Sequencing and Their Effects on Bilirubin Levels in Obese Children. Genet Test Mol Biomarkers 2024; 28:275-280. [PMID: 38916116 PMCID: PMC11304751 DOI: 10.1089/gtmb.2023.0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
Background and Objectives: Obesity is a major nutritional problem with an increasing prevalence among children and adolescents. The uridine-diphosphate-glucuronosyl-transferase1A1 (UGT1A1) gene encodes the UDP-glucuronosyl transferase enzyme, converting the toxic form of bilirubin to a soluble, nontoxic form. There are yet to be studies on the evaluation of the UGT1A1 variant types detected by next-generation sequencing (NGS) and their effects on bilirubin levels in nonsyndromic obese children. Methods: Forty-five children with body mass index (BMI) >95 percentile (p) constituted the obesity group and fourteen healthy children with BMI <85p constituted the control group. Anthropometric, clinical features, and biochemical parameters were evaluated. Furthermore, the UGT1A1 gene was sequenced by NGS. Results: The obese patients had lower total, direct, and indirect bilirubin levels (p = 0.422, 0.026, and 0.568, respectively). In addition, obese patients had more genetic variations in the UGT1A1 gene compared with the control group (62.2% and 50%, respectively). We found that children with variations had higher total direct and indirect bilirubin levels compared with those without variation (p = 0.016, 0.028, and 0.015, respectively). Children diagnosed with obesity in the first two years of their life had fewer genetic variations and lower total bilirubin levels (p = 0.000 and 0.013, respectively). Conclusions: It is assumed that bilirubin can be protective against many chronic diseases. Although bilirubin levels are found to be lower in obese children compared with the control group, some variations in the UGT1A1 gene may be supported by raising bilirubin. We suggest that high bilirubin levels caused by those UGT1A1 variations may be protective against obesity and its many negative effects.
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Affiliation(s)
- Merve Aslantas
- Department of Pediatric Nutrition and Metabolism, Çam and Sakura City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Onder Kilicaslan
- Department of Pediatric Infection Diseases, Prof. Dr. Cemil Taşçıoğlu City Hospital, Istanbul, Turkey
| | - Recep Eröz
- Department of Medical Genetics, Aksaray University Medical Faculty, Aksaray, Turkey
| | - Kenan Kocabay
- Department of Pediatrics, Duzce University Medical Faculty, Duzce, Turkey
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Zhao Y, Zhu W, Wang M, Cai L, Zheng X, Jin L. High serum total bilirubin as a potential protective factor for gestational diabetes mellitus: A retrospective cohort study of 92,885 Chinese pregnant women. DIABETES & METABOLISM 2024; 50:101523. [PMID: 38341132 DOI: 10.1016/j.diabet.2024.101523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/04/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
AIMS Identifying physiological factors that could reduce pregnant women's risk for developing gestational diabetes mellitus (GDM) is crucial for early prevention and intervention. We aimed to examine whether higher serum levels of total bilirubin (TBIL) were associated with a decreased risk of GDM. METHODS We conducted a retrospective cohort study in a tertiary care hospital in Shanghai, China. A total of 92,885 pregnant women were included. Serum TBIL levels were determined during the first antenatal visit before 24 weeks of gestation and GDM was diagnosed with a 75-g oral glucose tolerance test (OGTT) at 24-28 weeks of gestation. RESULTS A total of 13,037 GDM cases were identified, a prevalence of 14.0 % (13,037/92,885). These women had a higher median TBIL concentration 7.9 versus 7.6 mmol/l (P < 0.001). For the 91,051 women with TBIL within the physiologically normal range (≤ 17.1 μmol/l), a one interquartile range increase in TBIL (3.4 μmol/l) was associated with a decreased risk of GDM: adjusted odds ratio (OR)=0.89 [95 % CI 0.87;0.92]. For these women, the adjusted ORs for GDM across TBIL quartiles were: 0.92 [0.88;0.97] for the second, 0.85 [0.81;0.90] for the third, and 0.78 [0.74;0.83] for the fourth quartile in comparison with the first quartile. CONCLUSION Our study demonstrated that elevated serum TBIL levels were associated with decreased risk of GDM and supported its potential role in the prevention and early intervention of GDM.
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Affiliation(s)
- Yan Zhao
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China; Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China
| | - Wenyu Zhu
- Institute of Clinical Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Miao Wang
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Luyi Cai
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xueying Zheng
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
| | - Liping Jin
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China; Hospital of Obstetrics and Gynecology, Shanghai Medical School, Fudan University, Shanghai, China.
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Che Y, Tang R, Zhang H, Yang M, Geng R, Zhuo L, Wang P, Hu X, Zhou Y, Wang P, Zhan S, Li B. Development of a prediction model for predicting the prevalence of nonalcoholic fatty liver disease in Chinese nurses: the first-year follow data of a web-based ambispective cohort study. BMC Gastroenterol 2024; 24:72. [PMID: 38355421 PMCID: PMC10868006 DOI: 10.1186/s12876-024-03121-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/01/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is gradually becoming a huge threat to public health. With complex working characteristics, female nurses had been found with high risk of NAFLD. To develop and validate a prediction model to predict the prevalence of NAFLD based on demographic characteristics, work situation, daily lifestyle and laboratory tests in female nurses. METHODS This study was a part of the Chinese Nurse Cohort Study (The National Nurse Health Study, NNHS), and data were extracted from the first-year follow data collected from 1st June to 1st September 2021 by questionnaires and physical examination records in a comprehensive tertiary hospital. The questionnaires included demographic characteristics, work situation and daily lifestyle. Logistic regression and a nomogram were used to develop and validate the prediction model. RESULTS A total of 824 female nurses were included in this study. Living situation, smoking history, monthly night shift, daily sleep time, ALT/AST, FBG, TG, HDL-C, UA, BMI, TBil and Ca were independent risk factors for NAFLD occurance. A prediction model for predicting the prevalence of NAFLD among female nurses was developed and verified in this study. CONCLUSION Living situation, smoking history, monthly night shift, daily sleep time, ALT/AST, FBG, TG, UA, BMI and Ca were independent predictors, while HDL-C and Tbil were independent protective indicators of NAFLD occurance. The prediction model and nomogram could be applied to predict the prevalence of NAFLD among female nurses, which could be used in health improvement. TRIAL REGISTRATION This study was a part of the Chinese Nurse Cohort Study (The National Nurse Health Study, NNHS), which was a ambispective cohort study contained past data and registered at Clinicaltrials.gov ( https://clinicaltrials.gov/ct2/show/NCT04572347 ) and the China Cohort Consortium ( http://chinacohort.bjmu.edu.cn/project/102/ ).
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Affiliation(s)
- Ying Che
- Medical Examination Center, Peking university third hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Rongsong Tang
- Nursing Department, Peking University Third Hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Heli Zhang
- Department of Rehabilitation Medicine, Peking University Third Hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Min Yang
- Nursing Department, Peking University Third Hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Rongmei Geng
- Nursing Department, Peking University Third Hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Lin Zhuo
- Center for Clinical Epidemiology Research, Peking University Third Hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Peng Wang
- Medical Examination Center, Peking university third hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Xianjing Hu
- School of Nursing, Peking university, Xueyuan Road No. 38, Haidian District, Beijing, China
| | - Yujie Zhou
- General surgery department, Peking university third hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Panfeng Wang
- Oncology Radiotherapy Department, Peking university third hospital, Huayuan North Road No.49, Haidian District, Beijing, China
| | - Siyan Zhan
- Center for Clinical Epidemiology Research, Peking University Third Hospital, Huayuan North Road No.49, Haidian District, Beijing, China.
| | - Baohua Li
- Nursing Department, Peking University Third Hospital, Huayuan North Road No.49, Haidian District, Beijing, China.
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Jayanti S, Vitek L, Verde CD, Llido JP, Sukowati C, Tiribelli C, Gazzin S. Role of Natural Compounds Modulating Heme Catabolic Pathway in Gut, Liver, Cardiovascular, and Brain Diseases. Biomolecules 2024; 14:63. [PMID: 38254662 PMCID: PMC10813662 DOI: 10.3390/biom14010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/24/2024] Open
Abstract
The crucial physiological process of heme breakdown yields biliverdin (BV) and bilirubin (BR) as byproducts. BV, BR, and the enzymes involved in their production (the "yellow players-YP") are increasingly documented as endogenous modulators of human health. Mildly elevated serum bilirubin concentration has been correlated with a reduced risk of multiple chronic pro-oxidant and pro-inflammatory diseases, especially in the elderly. BR and BV per se have been demonstrated to protect against neurodegenerative diseases, in which heme oxygenase (HMOX), the main enzyme in the production of pigments, is almost always altered. HMOX upregulation has been interpreted as a tentative defense against the ongoing pathologic mechanisms. With the demonstration that multiple cells possess YP, their propensity to be modulated, and their broad spectrum of activity on multiple signaling pathways, the YP have assumed the role of an adjustable system that can promote health in adults. Based on that, there is an ongoing effort to induce their activity as a therapeutic option, and natural compounds are an attractive alternative to the goal, possibly requiring only minimal changes in the life style. We review the most recent evidence of the potential of natural compounds in targeting the YP in the context of the most common pathologic condition of adult and elderly life.
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Affiliation(s)
- Sri Jayanti
- Liver brain Unit “Rita Moretti”, Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163,5, Basovizza, 34149 Trieste, Italy or (S.J.); (C.D.V.); (J.P.L.); or (C.S.); (C.T.)
- Eijkman Research Centre for Molecular Biology, Research Organization for Health, National Research and Innovation Agency, Cibinong 16915, Indonesia
| | - Libor Vitek
- Institute of Medical Biochemistry and Laboratory Diagnostics, and 4th Department of Internal Medicine, General University Hospital and 1st Faculty of Medicine, Charles University, 12000 Prague, Czech Republic;
| | - Camilla Dalla Verde
- Liver brain Unit “Rita Moretti”, Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163,5, Basovizza, 34149 Trieste, Italy or (S.J.); (C.D.V.); (J.P.L.); or (C.S.); (C.T.)
- Department of Life Sciences, University of Trieste, 34139 Trieste, Italy
| | - John Paul Llido
- Liver brain Unit “Rita Moretti”, Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163,5, Basovizza, 34149 Trieste, Italy or (S.J.); (C.D.V.); (J.P.L.); or (C.S.); (C.T.)
- Department of Life Sciences, University of Trieste, 34139 Trieste, Italy
- Department of Science and Technology, Philippine Council for Health Research and Development, Bicutan, Taguig City 1631, Philippines
| | - Caecilia Sukowati
- Liver brain Unit “Rita Moretti”, Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163,5, Basovizza, 34149 Trieste, Italy or (S.J.); (C.D.V.); (J.P.L.); or (C.S.); (C.T.)
- Eijkman Research Centre for Molecular Biology, Research Organization for Health, National Research and Innovation Agency, Cibinong 16915, Indonesia
| | - Claudio Tiribelli
- Liver brain Unit “Rita Moretti”, Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163,5, Basovizza, 34149 Trieste, Italy or (S.J.); (C.D.V.); (J.P.L.); or (C.S.); (C.T.)
| | - Silvia Gazzin
- Liver brain Unit “Rita Moretti”, Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163,5, Basovizza, 34149 Trieste, Italy or (S.J.); (C.D.V.); (J.P.L.); or (C.S.); (C.T.)
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Puerto-Carranza E, Nuevo-Casals S, Roca-Portella B, Mas-Parés B, Gómez-Vilarrubla A, Carreras-Badosa G, Niubó M, Prats-Puig A, de Zegher F, Ibáñez L, Bassols J, López-Bermejo A. Total bilirubin and bilirubin-to-triglycerides ratio predict changes in glycated hemoglobin in healthy children. Front Endocrinol (Lausanne) 2023; 14:1303597. [PMID: 38107514 PMCID: PMC10722262 DOI: 10.3389/fendo.2023.1303597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 11/16/2023] [Indexed: 12/19/2023] Open
Abstract
Objective Bilirubin and triglycerides can regulate insulin secretion and glucose uptake. The aim of our study is to analyze associations between total bilirubin (TB) and the bilirubin-to-triglycerides ratio (BTR) with metabolic markers in healthy prepubertal children. Methods Subjects were 246 healthy children (mean age 8), of whom 142 (58%) were reevaluated 4 years later (mean age 12). The subjects were stratified according to age into three groups (<7.8 years; 7.8-9.6 years; and >9.6 years; n=82 each) at baseline and into two groups (<12.9 years and ≥12.9 years; n=71 each) at follow-up. Anthropometrics and laboratory parameters [TB and its fractions (direct and indirect bilirubin), triglycerides, HDL-cholesterol, glucose, insulin, HOMA-IR, HOMA-B and glycated hemoglobin (HbA1c)] were assessed at both baseline and follow-up. Results TB and BTR showed independent and negative association with baseline and follow-up HbA1c. These associations were stronger for BTR and in the highest age group. No independent associations were observed with HOMA-IR or HOMA-B. Conclusion TB and BTR are independently associated with HbA1c and predict its changes over time in healthy children. Our results indicate that TB and BTR may be useful parameters in studies of glucose tolerance in healthy children.
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Affiliation(s)
- Elsa Puerto-Carranza
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
- Pediatrics, Dr. Trueta University Hospital, Girona, Spain
| | | | | | - Berta Mas-Parés
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | | | - Gemma Carreras-Badosa
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Maria Niubó
- Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Anna Prats-Puig
- University School of Health and Sport (EUSES), University of Girona, Girona, Spain
| | - Francis de Zegher
- Department of Development & Regeneration, University of Leuven, Leuven, Belgium
| | - Lourdes Ibáñez
- Endocrinology, Pediatric Research Institute, Sant Joan de Déu Children’s Hospital, Esplugues, Barcelona, Spain
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), ISCIII, Madrid, Spain
| | - Judit Bassols
- Maternal-Fetal Metabolic Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Group, Girona Biomedical Research Institute (IDIBGI), Salt, Spain
- Pediatrics, Dr. Trueta University Hospital, Girona, Spain
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Ullah A, Stankevic E, Holm LA, Stinson SE, Juel HB, Fonvig CE, Lund MAV, Trier C, Engelbrechtsen L, Ängquist L, Jonsson AE, Pedersen O, Grarup N, Holm JC, Hansen T. Genetics of Plasma Bilirubin and Associations between Bilirubin and Cardiometabolic Risk Profiles in Danish Children and Adolescents. Antioxidants (Basel) 2023; 12:1613. [PMID: 37627608 PMCID: PMC10451688 DOI: 10.3390/antiox12081613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
Bilirubin is the end product of heme catabolism, mainly produced by the breakdown of mature red blood cells. Due to its anti-inflammatory, antioxidant, antidiabetic, and antilipemic properties, circulating bilirubin concentrations are inversely associated with the risk of cardiovascular disease, type 2 diabetes, and all-cause mortality in adults. Some genetic loci associated with circulating bilirubin concentrations have been identified by genome-wide association studies in adults. We aimed to examine the relationship between circulating bilirubin, cardiometabolic risk factors, and inflammation in children and adolescents and the genetic architecture of plasma bilirubin concentrations. We measured fasting plasma bilirubin, cardiometabolic risk factors, and inflammatory markers in a sample of Danish children and adolescents with overweight or obesity (n = 1530) and in a population-based sample (n = 1820) of Danish children and adolescents. Linear and logistic regression analyses were performed to analyze the associations between bilirubin, cardiometabolic risk factors, and inflammatory markers. A genome-wide association study (GWAS) of fasting plasma concentrations of bilirubin was performed in children and adolescents with overweight or obesity and in a population-based sample. Bilirubin is associated inversely and significantly with a number of cardiometabolic risk factors, including body mass index (BMI) standard deviation scores (SDS), waist circumference, high-sensitivity C-reactive protein (hs-CRP), homeostatic model assessment for insulin resistance (HOMA-IR), hemoglobin A1c (HbA1c), low-density lipoprotein cholesterol (LDL-C), triglycerides, and the majority of measured inflammatory markers. In contrast, bilirubin was positively associated with fasting plasma concentrations of alanine transaminase (ALT), high-density lipoprotein cholesterol (HDL-C), systolic blood pressure (SDS), and the inflammatory markers GH, PTX3, THBS2, TNFRSF9, PGF, PAPPA, GT, CCL23, CX3CL1, SCF, and TRANCE. The GWAS showed that two loci were positively associated with plasma bilirubin concentrations at a p-value threshold of <5 × 10-8 (rs76999922: β = -0.65 SD; p = 4.3 × 10-8, and rs887829: β = 0.78 SD; p = 2.9 × 10-247). Approximately 25% of the variance in plasma bilirubin concentration was explained by rs887829. The rs887829 was not significantly associated with any of the mentioned cardiometabolic risk factors except for hs-CRP. Our findings suggest that plasma concentrations of bilirubin non-causally associates with cardiometabolic risk factors in children and adolescents.
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Affiliation(s)
- Asmat Ullah
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Evelina Stankevic
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Louise Aas Holm
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
- The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark; (M.A.V.L.); (C.T.)
| | - Sara E. Stinson
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Helene Bæk Juel
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Cilius E. Fonvig
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
- The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark; (M.A.V.L.); (C.T.)
- The Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Morten A. V. Lund
- The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark; (M.A.V.L.); (C.T.)
| | - Cæcilie Trier
- The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark; (M.A.V.L.); (C.T.)
| | - Line Engelbrechtsen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Lars Ängquist
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Anna E. Jonsson
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Oluf Pedersen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
- Clinical Center for Metabolic Research, Herlev-Gentofte University Hospital, 2900 Copenhagen, Denmark
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
| | - Jens-Christian Holm
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
- The Children’s Obesity Clinic, Accredited European Centre for Obesity Management, Department of Pediatrics, Holbæk Hospital, 4300 Holbæk, Denmark; (M.A.V.L.); (C.T.)
- The Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Torben Hansen
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark or (A.U.); (E.S.); (L.A.H.); (S.E.S.); (H.B.J.); (C.E.F.); (L.E.); (L.Ä.); (A.E.J.); (O.P.); (N.G.)
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Li J, Xin Y, Li J, Meng M, Zhou L, Qiu H, Chen H, Li H. The predictive effect of direct-indirect bilirubin ratio on clinical events in acute coronary syndrome: results from an observational cohort study in north China. BMC Cardiovasc Disord 2022; 22:478. [DOI: 10.1186/s12872-022-02894-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background:
Patients with extremely high-risk ASCVD usually suffered poor prognosis, bilirubin is considered closely related to cardiovascular outcomes. However, there is controversy over the relationship between bilirubin and coronary artery disease. This study aimed to evaluate the predictive value of the DIBIL ratio in patients with extremely high-risk ASCVD.
Methods:
10,260 consecutive patients with extremely high-risk ASCVD were enrolled in this study. All patients were divided into three groups according to their DIBIL ratio. The incidence of MACCEs was recorded, and in a competing risk regression, the incidence of MACCEs and their subgroups were recorded. The direct-indirect bilirubin ratio (DIBIL ratio) was calculated by the direct bilirubin (umol/L)/indirect bilirubin (umol/L) ratio, all laboratory values were obtained from the first fasting blood samples during hospitalization.
Results:
The area under the ROC curve of the DIBIL ratio to predict the occurrence of all-cause death was 0.668, the cut-off value of which is 0.275. Competing risk regression indicated that DIBIL ratio was positively correlated with all-cause death [1.829 (1.405–2.381), p < 0.001], CV death [1.600 (1.103, 2.321), p = 0.013]. The addition of DIBIL ratio to a baseline risk model had an incremental effect on the predictive value for all-cause death [IDI 0.004(0, 0.010), p < 0.001; C-index 0.805(0.783–0.827), p < 0.001].
Conclusion:
The DIBIL ratio was an excellent tool to predict poor prognosis, suggesting that this index may be developed as a biomarker for risk stratification and prognosis in extremely ASCVD patients.
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10
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Liu X, Wang X, Wen C, Wan L. Decision tree distinguish affective disorder diagnosis from psychotic disorder diagnosis with clinical and lab factors. Heliyon 2022; 8:e11514. [PMID: 36406667 PMCID: PMC9672315 DOI: 10.1016/j.heliyon.2022.e11514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/18/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Affective symptoms usually occur at the same time of psychotic symptoms. An effective predictive method would help the differential diagnosis at an early stage of the mental disorder. The purpose of the study was to establish a predictive model by using laboratory indexes and clinical factors to improve the diagnostic accuracy. Methods Subjects were patients diagnosed with psychiatric disorders with affective and/or psychotic symptoms. Two patient samples were collected in the study (n = 309) With three classification methods (logistic regression, decision tree, and discriminant analysis), we established the models and verified the models. Results Seven predictors were found to be significant to distinguish the affective disorder diagnosis from the psychotic disorder diagnosis in all three methods, the 7 factors were Activities of daily living, direct bilirubin, apolipoproteinA1, lactic dehydrogenase, creatinine, monocyte count and interleukin-8. The decision tree outperformed the other 2 methods in area under the receiver operating characteristic curve, and also had the highest percentage of correctly classification. Conclusion We established a predictive model that included activities of daily living, biochemical, and immune indicators. In addition, the model established by the decision tree method had the highest predictive power, which provided a reliable basis for future clinical work. Our work would help make diagnosis more accurate at an early stage of the disorder.
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11
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Blood and Urinary Biomarkers of Antipsychotic-Induced Metabolic Syndrome. Metabolites 2022; 12:metabo12080726. [PMID: 36005598 PMCID: PMC9416438 DOI: 10.3390/metabo12080726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 12/15/2022] Open
Abstract
Metabolic syndrome (MetS) is a clustering of at least three of the following five medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum high-density lipoprotein (HDL). Antipsychotic (AP)-induced MetS (AIMetS) is the most common adverse drug reaction (ADR) of psychiatric pharmacotherapy. Herein, we review the results of studies of blood (serum and plasma) and urinary biomarkers as predictors of AIMetS in patients with schizophrenia (Sch). We reviewed 1440 studies examining 38 blood and 19 urinary metabolic biomarkers, including urinary indicators involved in the development of AIMetS. Among the results, only positive associations were revealed. However, at present, it should be recognized that there is no consensus on the role of any particular urinary biomarker of AIMetS. Evaluation of urinary biomarkers of the development of MetS and AIMetS, as one of the most common concomitant pathological conditions in the treatment of patients with psychiatric disorders, may provide a key to the development of strategies for personalized prevention and treatment of the condition, which is considered a complication of AP therapy for Sch in clinical practice.
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12
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Hertiš Petek T, Petek T, Močnik M, Marčun Varda N. Systemic Inflammation, Oxidative Stress and Cardiovascular Health in Children and Adolescents: A Systematic Review. Antioxidants (Basel) 2022; 11:894. [PMID: 35624760 PMCID: PMC9137597 DOI: 10.3390/antiox11050894] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/16/2022] [Accepted: 04/24/2022] [Indexed: 12/02/2022] Open
Abstract
Recent studies indicate that cerebrovascular diseases and processes of atherosclerosis originate in the childhood era and are largely influenced by chronic inflammation. Some features of vascular dysfunction in adulthood may even be programmed prenatally via genetic influences and an unfavorable intrauterine milieu. Oxidative stress, defined by an imbalance between the production and generation of reactive oxygen species (ROS) in cells and tissues and the capability of an organism to scavenge these molecules via antioxidant mechanisms, has been linked to adverse cardiovascular health in adults, yet has not been systematically reviewed in the pediatric population. We performed a systematic search as per the PRISMA guidelines in PubMed/Medline and Cochrane Reviews and detected, in total, 1228 potentially eligible pediatric articles on systemic inflammation, oxidative stress, antioxidant use, cardiovascular disease and endothelial dysfunction. The abstracts and full-text manuscripts of these were screened for inclusion and exclusion criteria, and a total of 160 articles were included. The results indicate that systemic inflammation and oxidative stress influence cardiovascular health in many chronic pediatric conditions, including hypertension, obesity, diabetes mellitus types 1 and 2, chronic kidney disease, hyperlipidemia and obstructive sleep apnea. Exercise and diet may diminish ROS formation and enhance the total serum antioxidant capacity. Antioxidant supplementation may, in selected conditions, contribute to the diminution of the oxidative state and improve endothelial function; yet, in many areas, studies provide unsatisfactory results.
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Affiliation(s)
- Tjaša Hertiš Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Tadej Petek
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Mirjam Močnik
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
| | - Nataša Marčun Varda
- Department of Paediatrics, University Medical Centre Maribor, Ljubljanska 5, 2000 Maribor, Slovenia; (T.H.P.); (M.M.); (N.M.V.)
- Faculty of Medicine, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
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13
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Zanussi JT, Zhao J, Dorn CA, Liu G, Feng Q, Wei W, Mosley JD, Stein CM, Kawai VK. Identifying Potential Therapeutic Applications and Diagnostic Harms of Increased Bilirubin Concentrations: A Clinical and Genetic Approach. Clin Pharmacol Ther 2022; 111:435-443. [PMID: 34625956 PMCID: PMC8748314 DOI: 10.1002/cpt.2441] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 09/16/2021] [Indexed: 02/03/2023]
Abstract
Bilirubin has antioxidant and anti-inflammatory properties in vitro and in animal studies and protects against inflammatory, cardiovascular, and other diseases in observational studies; therefore, bilirubin has potential as a therapeutic agent. However, observational studies could be confounded by many factors. We used a genetic (n = 61,281) and clinical (n = 234,670) approach to define the association between bilirubin and 19 conditions with a putative protective signal in observational studies. We also tested if individuals with genetically higher bilirubin levels underwent more diagnostic tests. We used a common variant in UGT1A1 (rs6742078) associated with an 26% increase in bilirubin levels in the genetic studies. Carriers of the variant had higher bilirubin levels (P = 2.2 × 10-16 ) but there was no significant association with any of the 19 conditions. In a phenome-wide association study (pheWAS) to seek undiscovered genetic associations, the only significant finding was increased risk of "jaundice-not of newborn." Carriers of the variant allele were more likely to undergo an abdominal ultrasound (odds ratio = 1.04, [1.00-1.08], P = 0.03). In contrast, clinically measured bilirubin levels were significantly associated with 15 of the 19 conditions (P < 0.003) and with 431 clinical diagnoses in the pheWAS (P < 1 × 10-5 adjusted for sex, age, and follow-up). With additional adjustment for smoking and body mass index, 7 of 19 conditions and 260 pheWAS diagnoses remained significantly associated with bilirubin levels. In conclusion, bilirubin does not protect against inflammatory or other diseases using a genetic approach; the many putative beneficial associations reported clinically are likely due to confounding.
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Affiliation(s)
- Jacy T. Zanussi
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Juan Zhao
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Chad A. Dorn
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Ge Liu
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - QiPing Feng
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - WeiQi Wei
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jonathan D. Mosley
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Biomedical Informatics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - C. Michael Stein
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Vivian K. Kawai
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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14
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Liang C, Yu Z, Bai L, Hou W, Tang S, Zhang W, Chen X, Hu Z, Duan Z, Zheng S. Association of Serum Bilirubin With Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:869579. [PMID: 35937795 PMCID: PMC9346511 DOI: 10.3389/fendo.2022.869579] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/20/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) are the leading chronic diseases worldwide. There are still many controversies about the association between serum bilirubin and MetS or NAFLD. This study aims to evaluate the association of serum total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL) with MetS and NAFLD. METHODS Multiple databases were searched for relevant studies until November 2021. Randomized controlled trials, cross-sectional and cohort studies evaluating the association between serum bilirubin levels and MetS or NAFLD were included. RESULTS Twenty-four cross-sectional and cohort studies with 101, 517 participants were finally analyzed. Fifteen studies and 6 studies evaluated the association between bilirubin and MetS or NAFLD in health screening population, respectively, while 3 studies evaluated the association between bilirubin and non-alcoholic steatohepatitis (NASH) in NAFLD patients. Random effect model analysis showed the inverse association between TBIL and MetS in male (95%CI=0.71-0.96) and gender-neutral (95%CI=0.61-0.91) group. However, no significant association was found in females. Notably, the inverse association between DBIL and MetS was noticed in male (95%CI=0.36-0.75), female (95%CI=0.16-0.58) and gender-neutral population (95%CI=0.67-0.92). IBIL level was inversely associated with MetS in females (95%CI=0.52-0.96), whereas no statistical correlation presented in males. TBIL was not statistically correlated with NAFLD in gender-neutral or male subgroup. Similarly, there were no association between DBIL or IBIL and NAFLD in gender-neutral subgroup. However, the negative correlation between DBIL and NAFLD existed in males (95%CI=0.76-0.96). In NAFLD patients, IBIL analysis showed an inverse association with NASH (95%CI=0.01-0.12). CONCLUSION Serum TBIL and DBIL levels, especially DBIL levels, assume an inverse correlation with MetS in healthy population. Serum IBIL is inversely associated with the onset and degree of NASH in NAFLD patients. Exogenous bilirubin supplement may be a potential strategy to assist in lowering the risk of developing MetS and NAFLD. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero/, identifier CRD42021293349.
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Affiliation(s)
- Chen Liang
- First Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Zhiyuan Yu
- School of Medicine, Nankai University, Tianjin, China
- Department of General Surgery, The First Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Li Bai
- Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing You'an Hospital, Capital Medical University, Beijing, China
- Fourth Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Wei Hou
- First Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Shan Tang
- First Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- First Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Xinyue Chen
- First Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Zhongjie Hu
- First Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Zhongping Duan
- Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment Research, Beijing You'an Hospital, Capital Medical University, Beijing, China
- Fourth Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
| | - Sujun Zheng
- First Department of Liver Disease, Beijing You'an Hospital, Capital Medical University, Beijing, China
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15
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Bilirubin deficiency renders mice susceptible to hepatic steatosis in the absence of insulin resistance. Redox Biol 2021; 47:102152. [PMID: 34610553 PMCID: PMC8498001 DOI: 10.1016/j.redox.2021.102152] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/26/2021] [Accepted: 09/26/2021] [Indexed: 12/31/2022] Open
Abstract
Background & aims Plasma concentrations of bilirubin, a product of heme catabolism formed by biliverdin reductase A (BVRA), inversely associate with the risk of metabolic diseases including hepatic steatosis and diabetes mellitus in humans. Bilirubin has antioxidant and anti-inflammatory activities and may also regulate insulin signaling and peroxisome proliferator-activated receptor alpha (PPARα) activity. However, a causal link between bilirubin and metabolic diseases remains to be established. Here, we used the global Bvra gene knockout (Bvra–/–) mouse as a model of deficiency in bilirubin to assess its role in metabolic diseases. Approach & results We fed mice fat-rich diets to induce hepatic steatosis and insulin resistance. Bile pigments were measured by LC-MS/MS, and hepatic lipids by LC-MS/MS (non-targeted lipidomics), HPLC-UV and Oil-Red-O staining. Oxidative stress was evaluated measuring F2-isoprostanes by GC-MS. Glucose metabolism and insulin sensitivity were verified by glucose and insulin tolerance tests, ex vivo and in vivo glucose uptake, and Western blotting for insulin signaling. Compared with wild type littermates, Bvra–/– mice contained negligible bilirubin in plasma and liver, and they had comparable glucose metabolism and insulin sensitivity. However, Bvra–/– mice exhibited an inflamed and fatty liver phenotype, accompanied by hepatic accumulation of oxidized triacylglycerols and F2-isoprostanes, in association with depletion of α-tocopherol. α-Tocopherol supplementation reversed the hepatic phenotype and observed biochemical changes in Bvra–/– mice. Conclusions Our data suggests that BVRA deficiency renders mice susceptible to oxidative stress-induced hepatic steatosis in the absence of insulin resistance. Low plasma levels of bilirubin associate with increased metabolic disease risk. A direct link between bilirubin and metabolic disease remains to be established. Global BVRA deficiency causes global bilirubin deficiency and a fatty, inflamed liver. This hepatic phenotype is linked to decreased vitamin E and increased lipid oxidation. Vitamin E supplements restore normal liver phenotype in BVRA deficiency.
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16
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Association of Serum Total Bilirubin Concentration with Telomere Length: The National Health and Nutrition Examination Survey. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:4688900. [PMID: 34603596 PMCID: PMC8486523 DOI: 10.1155/2021/4688900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/09/2021] [Accepted: 09/16/2021] [Indexed: 12/18/2022]
Abstract
Introduction Mildly increased bilirubin concentration has a protective effect on oxidative stress–related diseases. However, it remains unknown whether elevated circulating bilirubin is associated with longer telomere length. The aim of this cross-sectional study was to examine the association between total bilirubin concentration and telomere length. Methods We used the data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. The multivariable linear regression model was used to examine the association between total bilirubin concentration and telomere length. The nonlinear relationship was analyzed using a generalized additive model with the smoothing plot. Results A total of 7818 participants with a mean age of 49.20 ± 18.82 years were included. Compared with the lowest concentration of total bilirubin (Q1), the highest quartile of total bilirubin concentration was associated with longer telomere length in male (β = 0.04, 95 CI%: 0.00, 0.07, P = 0.024) and female (β = 0.04, 95 CI%: 0.02, 0.04, P = 0.002). Furthermore, an inverted U-shaped relationship between total bilirubin and telomere length was found. On the left of turning points (total bilirubin < 0.5 mg/dL), total bilirubin concentration was positively associated with telomere length (β = 0.23, 95 CI%: 0.14, 0.32, P < 0.001). However, the association between total bilirubin concentration and telomere length was not significant (β = 0.01, 95% CI: -0.01, 0.04, P = 0.346) above the turning point. Conclusion This is the first evidence based on a nationally representative survey demonstrating a positive and nonlinear association between total bilirubin concentration and telomere length. Future large-scale prospective studies are warranted to confirm our findings.
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Basarir G, Ozcabi B, Aksu Sayman O, Ozturkmen Akay H, Yildiz FM. Evaluation of clinical, endocrine and metabolic findings in obese children with and without hepatosteatosis. J Pediatr Endocrinol Metab 2021; 34:1081-1087. [PMID: 34142516 DOI: 10.1515/jpem-2021-0034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/12/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Non-alcoholic fatty liver disease (NAFLD) is a common obesity-related comorbidity in childhood. In this study, we aimed to evaluate predictors of NAFLD by comparing clinical, endocrine and metabolic findings in obese children with and without hepatosteatosis. METHODS Two hundred and eight obese children aged 6-18 years were included. The patients were divided into group 1 (patients with NAFLD, n=94) and group 2 (patients without NAFLD, n=114). Anthropometric measurements, pubertal stage, lipid profiles, fasting glucose and insulin, homeostatic model of assessment for insulin resistance (HOMA-IR), uric acid, total bilirubin, alanine aminotransferase (ALT), blood urea nitrogen, thyroid-stimulating hormone and free thyroxine parameters were compared retrospectively. RESULTS The mean body weight, body mass index (BMI), height, tri-ponderal mass index (TMI), insulin, HOMA-IR, triglyceride, ALT and uric acid values were significantly higher, while high-density lipoprotein-cholesterol (HDL-C) values were significantly lower in group 1. The 70.7% of obese children with hepatosteatosis and 83.9% of those without hepatosteatosis were correctly estimated by parameters including age, gender, ALT, HDL-C, fasting insulin and uric acid values. CONCLUSIONS Since obesity-associated hepatosteatosis induces various long-term metabolic impacts in children, early detection is of critical importance. Age, gender, TMI, BMI, ALT, HDL-C, fasting insulin and uric acid values may help to predict the risk of hepatosteatosis. Besides, we assessed whether TMI compared to BMI does not have a better utility in estimating obesity-induced hepatosteatosis in children. This is the first study to show the association between TMI and hepatosteatosis in children.
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Affiliation(s)
- Gunce Basarir
- Department of Pediatric Neurology, University of Health Sciences, Tepecik Training and Research Hospital, Konak, Izmir, Turkey
| | - Bahar Ozcabi
- Department of Pediatrics, Division of Pediatric Endocrinology, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Üsküdar, Istanbul, Turkey
| | - Ozden Aksu Sayman
- Department of Pediatrics, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | | | - Feyza M Yildiz
- Department of Pediatrics, Zeynep Kamil Women and Children's Diseases Training and Research Hospital, Üsküdar, Istanbul, Turkey
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Bellarosa C, Bedogni G, Bianco A, Cicolini S, Caroli D, Tiribelli C, Sartorio A. Association of Serum Bilirubin Level with Metabolic Syndrome and Non-Alcoholic Fatty Liver Disease: A Cross-Sectional Study of 1672 Obese Children. J Clin Med 2021; 10:jcm10132812. [PMID: 34202304 PMCID: PMC8268762 DOI: 10.3390/jcm10132812] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022] Open
Abstract
As in adults, obesity also plays a central role in the development of metabolic syndrome (MS) in children. Non-alcoholic fatty liver disease (NAFLD) is considered a manifestation of MS. Not only MS but also NAFLD seem to be inversely associated with serum bilirubin concentrations, an important endogenous tissue protector when only mild elevated. The aim of the study was to evaluate the association between serum bilirubin levels and the prevalence of MS and NAFLD in Italian obese children and adolescents. A retrospective cross-sectional study was performed in 1672 patients aged from 5 to 18 years. Clinical and laboratory parameters were assessed. NAFLD was measured by liver ultrasonography. The study was approved by the Ethical Committee of the Istituto Auxologico Italiano (research project code 1C021_2020, acronym BILOB). MS was present in 24% and fatty liver (FL) in 38% of this population. Bilirubin was not associated with FL and MS as a whole, but it was inversely associated only with selected components of MS, i.e., large WC, high blood pressure and high triglycerides. Our data suggest that bilirubin is not protective against MS and NAFLD in the presence of severe obesity.
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Affiliation(s)
- Cristina Bellarosa
- Italian Liver Foundation, 34149 Trieste, Italy; (G.B.); (A.B.); (C.T.)
- Correspondence:
| | - Giorgio Bedogni
- Italian Liver Foundation, 34149 Trieste, Italy; (G.B.); (A.B.); (C.T.)
| | - Annalisa Bianco
- Italian Liver Foundation, 34149 Trieste, Italy; (G.B.); (A.B.); (C.T.)
- Life Science Department, University of Trieste, 34127 Trieste, Italy
| | - Sabrina Cicolini
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Verbania, Italy; (S.C.); (D.C.); (A.S.)
| | - Diana Caroli
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Verbania, Italy; (S.C.); (D.C.); (A.S.)
| | - Claudio Tiribelli
- Italian Liver Foundation, 34149 Trieste, Italy; (G.B.); (A.B.); (C.T.)
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Verbania, Italy; (S.C.); (D.C.); (A.S.)
- Istituto Auxologico Italiano, IRCCS, Division of Auxology and Metabolic Diseases, 28824 Verbania, Italy
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Creeden JF, Gordon DM, Stec DE, Hinds TD. Bilirubin as a metabolic hormone: the physiological relevance of low levels. Am J Physiol Endocrinol Metab 2021; 320:E191-E207. [PMID: 33284088 PMCID: PMC8260361 DOI: 10.1152/ajpendo.00405.2020] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Recent research on bilirubin, a historically well-known waste product of heme catabolism, suggests an entirely new function as a metabolic hormone that drives gene transcription by nuclear receptors. Studies are now revealing that low plasma bilirubin levels, defined as "hypobilirubinemia," are a possible new pathology analogous to the other end of the spectrum of extreme hyperbilirubinemia seen in patients with jaundice and liver dysfunction. Hypobilirubinemia is most commonly seen in patients with metabolic dysfunction, which may lead to cardiovascular complications and possibly stroke. We address the clinical significance of low bilirubin levels. A better understanding of bilirubin's hormonal function may explain why hypobilirubinemia might be deleterious. We present mechanisms by which bilirubin may be protective at mildly elevated levels and research directions that could generate treatment possibilities for patients with hypobilirubinemia, such as targeting of pathways that regulate its production or turnover or the newly designed bilirubin nanoparticles. Our review here calls for a shift in the perspective of an old molecule that could benefit millions of patients with hypobilirubinemia.
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Affiliation(s)
- Justin F Creeden
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Darren M Gordon
- Department of Neurosciences, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - David E Stec
- Department of Physiology & Biophysics, Cardiorenal and Metabolic Diseases Research Center, University of Mississippi Medical Center, Jackson, Mississippi
| | - Terry D Hinds
- Department of Pharmacology and Nutritional Sciences, University of Kentucky College of Medicine, Lexington, Kentucky
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20
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Odeniyi I, Odife U, Fasanmade O, Ohwovoriole A. Surrogate markers and predictors of insulin resistance in Nigeria patients with Type 2 diabetes mellitus: A cross sectional study. JOURNAL OF CLINICAL SCIENCES 2021. [DOI: 10.4103/jcls.jcls_46_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Jayanti S, Vítek L, Tiribelli C, Gazzin S. The Role of Bilirubin and the Other "Yellow Players" in Neurodegenerative Diseases. Antioxidants (Basel) 2020; 9:E900. [PMID: 32971784 PMCID: PMC7555389 DOI: 10.3390/antiox9090900] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 02/07/2023] Open
Abstract
Bilirubin is a yellow endogenous derivate of the heme catabolism. Since the 1980s, it has been recognized as one of the most potent antioxidants in nature, able to counteract 10,000× higher intracellular concentrations of H2O2. In the recent years, not only bilirubin, but also its precursor biliverdin, and the enzymes involved in their productions (namely heme oxygenase and biliverdin reductase; altogether the "yellow players"-YPs) have been recognized playing a protective role in diseases characterized by a chronic prooxidant status. Based on that, there is an ongoing effort in inducing their activity as a therapeutic option. Nevertheless, the understanding of their specific contributions to pathological conditions of the central nervous system (CNS) and their role in these diseases are limited. In this review, we will focus on the most recent evidence linking the role of the YPs specifically to neurodegenerative and neurological conditions. Both the protective, as well as potentially worsening effects of the YP's activity will be discussed.
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Affiliation(s)
- Sri Jayanti
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (S.J.); (C.T.)
- Faculty of Medicine, Universitas Hasanuddin, Makassar 90245, Indonesia
- Molecular Biomedicine Ph.D. Program, University of Trieste, 34127 Trieste, Italy
| | - Libor Vítek
- Institute of Medical Biochemistry and Laboratory Diagnostics, and 4th Department of Internal Medicine, Faculty General Hospital and 1st Faculty of Medicine, Charles University, 12000 Prague, Czech Republic;
| | - Claudio Tiribelli
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (S.J.); (C.T.)
| | - Silvia Gazzin
- Fondazione Italiana Fegato-Onlus, Bldg. Q, AREA Science Park, ss14, Km 163.5, Basovizza, 34149 Trieste, Italy; (S.J.); (C.T.)
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22
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YILMAZ N, ÖZ C, EREN E, TEKELİ SÖ. Bilirubin metabolism and its role in atherosclerosis. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2020. [DOI: 10.25000/acem.699424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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23
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Serum Bilirubin Level as a Potential Marker for the Hearing Outcome in Severe-Profound Bilateral Sudden Deafness. Otol Neurotol 2020; 40:728-735. [PMID: 31135669 PMCID: PMC6594721 DOI: 10.1097/mao.0000000000002287] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Supplemental Digital Content is available in the text Objective: To investigate the association of serum bilirubin level with hearing outcomes in bilateral sudden sensorineural hearing loss (BSSHL) patients. Participants: One hundred thirteen in-patient BSSHL patients were consecutively enrolled between July 2008 and December 2015 in a tertiary center. Main Outcome Measures: Multivariable linear regression, generalized estimating equations (GEE), and stratified analyses were applied to examine the association between serum bilirubin level and hearing outcome measures such as final hearing threshold and absolute and relative hearing gains in BSSHL. Results: After full adjustment for potential confounders, total bilirubin levels (TBIL) were observed to be positively and independently associated with hearing outcomes as measured by final hearing (β [95% confidence interval {CI}]: −1.5 [−2.7, −0.2] dB HL per 1 μmol/L increase in TBIL) and absolute and relative hearing gains (β [95% CI]: 1.4 [0.2, 2.7] dB and 1.6 [0.2, 3.1] dB, respectively) in the severe to profound hearing loss subpopulation. Conclusions: Higher TBIL levels, within the normal or mildly elevated ranges, were independently and significantly associated with better hearing outcome in BSSHL patients with severe to profound hearing loss. Given bilirubin elevation treatments exist, our finding suggests a novel pharmacological strategy for this specific subpopulation.
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Petelin A, Jurdana M, Jenko Pražnikar Z, Žiberna L. SERUM BILIRUBIN CORRELATES WITH SERUM ADIPOKINES IN NORMAL WEIGHT AND OVERWEIGHT ASYMPTOMATIC ADULTS. Acta Clin Croat 2020; 59:19-29. [PMID: 32724271 PMCID: PMC7382891 DOI: 10.20471/acc.2020.59.01.03] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Overweight and obesity are considered as chronic low-grade inflammation accompanied by imbalanced production of adipokines. The aim of this study was to elucidate the relationship between serum bilirubin, which is an endogenous antioxidant with anti-inflammatory activity, and pro- and anti-inflammatory serum adipokines in asymptomatic normal weight and overweight individuals. Healthy men and women aged 25-49 participated in this cross-sectional study. All participants underwent fasting serological measurements of adipokines, interleukin-6, tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), total and direct serum bilirubin, and other biochemical parameters. Participants were divided into normal weight and overweight groups. We found a significant negative association between total bilirubin and CRP, TNF-α, visfatin and resistin values, and a significant positive association between total bilirubin and adiponectin values in both normal-weight and overweight groups. Importantly, after adjusting for body mass index, we also found a significant negative association between total serum bilirubin levels and both visfatin and CRP serum levels. Moreover, visfatin, resistin and CRP were predictors of the total serum bilirubin levels.
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Affiliation(s)
| | - Mihaela Jurdana
- 1Faculty of Health Sciences, University of Primorska, Izola, Slovenia; 2Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Zala Jenko Pražnikar
- 1Faculty of Health Sciences, University of Primorska, Izola, Slovenia; 2Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Lovro Žiberna
- 1Faculty of Health Sciences, University of Primorska, Izola, Slovenia; 2Institute of Pharmacology and Experimental Toxicology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Lan Y, Liu H, Liu J, Zhao H, Wang H. The Relationship Between Serum Bilirubin Levels and Peripheral Arterial Disease and Gender Difference in Patients With Hypertension: BEST Study. Angiology 2020; 71:340-348. [PMID: 32013527 DOI: 10.1177/0003319719900734] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We evaluated the relationship between serum bilirubin levels and ankle-brachial index (ABI) to determine whether gender affected the relationship between bilirubin levels and peripheral arterial disease (PAD) in patients with hypertension. A total of 543 patients were included in our studies (78 patients with PAD and 465 without PAD). Peripheral arterial disease was defined as ABI <0.90 for either and/or both sides. Serum bilirubin levels were measured with a vanadate oxidation method by using fasting venous blood samples. Serum total bilirubin (TBiL) and direct bilirubin (DBiL) levels were higher in males compared with females (both P < .05). Total bilirubin and DBiL were significantly lower in the PAD group. After adjustment for cardiovascular risk factors, PAD was independently negatively related to TBiL and DBiL, with odds ratios (OR) 0.914 (95% confidence interval [CI]: 0.845-0.990) and 0.748 (95% CI: 0.572-0.977). In addition, there was a relationship between PAD and bilirubin levels (TBiL-OR = 0.884, 95% CI: 0.792-0.985; DBiL-OR = 0.621; 95% CI: 0.424-0.909) only in males but not in females. Future studies should further evaluate whether interventions that increase serum bilirubin levels will have a particular role in PAD prevention in males.
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Affiliation(s)
- Yang Lan
- Vascular Medicine Center, Peking University Shougang Hospital, Beijing, China
| | - Huan Liu
- Vascular Medicine Center, Peking University Shougang Hospital, Beijing, China
| | - Jinbo Liu
- Vascular Medicine Center, Peking University Shougang Hospital, Beijing, China
| | - Hongwei Zhao
- Vascular Medicine Center, Peking University Shougang Hospital, Beijing, China
| | - Hongyu Wang
- Vascular Medicine Center, Peking University Shougang Hospital, Beijing, China
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Effects of stress-induced increases of corticosterone on circulating triglyceride levels, biliverdin concentration, and heme oxygenase expression. Comp Biochem Physiol A Mol Integr Physiol 2020; 240:110608. [DOI: 10.1016/j.cbpa.2019.110608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/30/2019] [Accepted: 10/30/2019] [Indexed: 12/13/2022]
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Zhang F, Guan W, Fu Z, Zhou L, Guo W, Ma Y, Gong Y, Jiang W, Liang H, Zhou H. Relationship between Serum Indirect Bilirubin Level and Insulin Sensitivity: Results from Two Independent Cohorts of Obese Patients with Impaired Glucose Regulation and Type 2 Diabetes Mellitus in China. Int J Endocrinol 2020; 2020:5681296. [PMID: 32802055 PMCID: PMC7411450 DOI: 10.1155/2020/5681296] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/01/2020] [Accepted: 06/17/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Serum bilirubin is an endogenous antioxidant that has protective effects against obesity-related metabolic diseases. OBJECTIVES This study aimed to evaluate the characteristics of total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) and their relationships with insulin sensitivity in obese patients with impaired glucose regulation and type 2 diabetes mellitus (IGR/T2DM) in China. Patients and Methods. Cohort 1 comprised obese patients (n = 71) was divided into the IGR/T2DM group (n = 38, obesity with IGR/T2DM) and control group (n = 33, obesity without IGR/T2DM). Insulin sensitivity was evaluated using the hyperinsulinemic-euglycemic clamp technique (HEC) with glucose disposal rate (GDR, M value). Cohort 2 comprised obese patients with IGR/T2DM who underwent metabolic surgery (n = 109) as complementary to cohort 1. Insulin sensitivity was evaluated with the Matsuda Index and homeostatic model assessment of insulin sensitivity (HOMA-IS). RESULTS In cohort 1, TBIL, DBIL, and IBIL were higher within the physiological range in the IGR/T2DM group compared with the control group; IBIL was positively correlated with M value (r = 0.342, p=0.044) in the IGR/T2DM group, and multivariate logistic regression showed that IBIL might be independent protective factors against insulin resistance (odds ratio (OR) = 0.602; 95% confidence interval (CI): 0.413-0.878; p=0.008). In cohort 2, at 1 month after metabolic surgery, serum bilirubin levels (TBIL, DBIL, and IBIL) increased, and the percentage change in IBIL was positively correlated with the change of the Matsuda Index (r = 0.195, p=0.045). CONCLUSIONS The relationships between different types of bilirubin and insulin sensitivity varied. Serum indirect bilirubin might be a protective factor that enhances insulin sensitivity.
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Affiliation(s)
- Fan Zhang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- Department of Endocrinology, The Third People's Hospital of Changzhou, Changzhou 213001, China
| | - Wei Guan
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Zhenzhen Fu
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Li Zhou
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wen Guo
- Department of Health Promotion Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yizhe Ma
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yingyun Gong
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wanzi Jiang
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hui Liang
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hongwen Zhou
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
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Associations between Neonatal Serum Bilirubin and Childhood Obesity in Term Infants. Sci Rep 2019; 9:14575. [PMID: 31601856 PMCID: PMC6787235 DOI: 10.1038/s41598-019-51043-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 09/23/2019] [Indexed: 11/24/2022] Open
Abstract
Inverse correlations between serum bilirubin level and obesity had been reported in adults. We aimed to investigate the associations between neonatal hyperbilirubinemia and childhood obesity. Data was obtained from the U.S. Collaborative Perinatal Project (CPP), a multicenter study from 1959 to 1976. Data of serum bilirubin in term newborns were used to observe the association with obesity at age of 7 years. Logistic regression models were performed to calculate adjusted odds ratios (aORs) for obesity. For children from the same mother sharing similar factors, Generalized Estimating Equation (GEE) model was used to correct for intracluster correlation. Relative to newborns with total serum bilirubin (TSB) < 3 mg/dl, there are lower risks for obesity in those with 3 mg/dl ≤ TSB < 6 mg/dl (aOR 0.91; 95%CI 0.81, 1.02), 6 mg/dl ≤ TSB < 9 mg/dl (aOR 0.88; 95%CI 0.78, 0.99), 9 mg/dl ≤ TSB<13 mg/dl (aOR 0.83; 95%CI 0.71, 0.98). By stratifying for subtypes of bilirubin, the inverse correlations only existed in exposure to unconjugated bilirubin. By using the GEE model correcting for intracluster correlations, the results are consistent. In summary, exposure to bilirubin up to 13 mg/dl is inversely associated with obesity at the age of 7 years in term infants.
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Majeed CN, Ahmad MI, Ahsan I, Anees MA, Maheshwari SK, Soliman EZ. Relation of total bilirubin and QT interval prolongation (from the Third National Health and Nutrition Examination Survey). Ann Noninvasive Electrocardiol 2019; 25:e12696. [PMID: 31498504 DOI: 10.1111/anec.12696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/12/2019] [Accepted: 08/22/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The association of bilirubin with cardiovascular disease (CVD) is controversial. We sought to explore the association of total bilirubin (TB) levels with QT interval in a multiracial cohort. METHODS A total of 6,627 participants (59.0 ± 13.3 years; 52.6% women, 49.7% Non-Hispanic Whites) without CVD from the Third National Health and Nutrition Examination Survey were included in this analysis. QT was automatically measured from digital 12-lead electrocardiogram in a central reading center. A multivariable logistic regression model was used to examine the cross-sectional association between tertiles of TB and prolonged QT interval (≥450 ms in men and ≥460 ms in women). RESULTS The prevalence of prolonged QT was higher among those with higher levels of TB (prolonged QT prevalence was 4.7%, 6.8%, and 7.0% across TB lower (0-0.4 mg/dl), middle (0.5-1.6 mg/dl), and higher (0.70-4.30 mg/dl) tertiles, respectively). In a model adjusted for potential confounders, participants within the highest TB tertile had significantly greater odds of the prolonged QT interval (Odds ratios [95% confidence interval] 1.53 [1.16-2.02]) compared to those with bilirubin levels in the first tertile. Each 0.29 mg/dl increase in TB levels was associated with a 12% (p-value <.0001) increase in the prevalence of prolonged QT interval. This association was stronger in men than in women (interaction p-value = .04). CONCLUSION Elevated bilirubin levels are associated with a prolonged QT interval. This finding extends our current knowledge on the relationship between serum bilirubin and CVD by demonstrating a link between higher TB and abnormal cardiac repolarization.
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Affiliation(s)
- Chaudry N Majeed
- Department of Internal Medicine, Section on Hospital Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Muhammad I Ahmad
- Department of Internal Medicine, Section on Hospital Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Irfan Ahsan
- Department of Internal Medicine, Section of Hospital Medicine, Geisinger Medical Center, Danville, Pennsylvania
| | | | | | - Elsayed Z Soliman
- Department of Epidemiology and Prevention, Epidemiological Cardiology Research Center (EPICARE), Wake Forest School of Medicine, Winston-Salem, North Carolina.,Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Sakaguchi C, Miura N, Ohara H, Nagata Y. Effects of reduced exposure to cigarette smoking on changes in biomarkers of potential harm in adult smokers: results of combined analysis of two clinical studies. Biomarkers 2019; 24:457-468. [PMID: 31084221 DOI: 10.1080/1354750x.2019.1609579] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 04/13/2019] [Indexed: 12/27/2022]
Abstract
Purpose: Nonconventional vapor products (NVP), designed to reduce exposure to cigarette smoke toxicants (CSTs), could cause changes in biomarkers of potential harm (BoPH). Although, NVPs reduced CSTs exposure compared to conventional cigarettes (CC), the changes in the BoPH values varied among the studies. Hence, further information on BoPH using NVPs is needed. Material and methods: The data of two similarly designed studies using a kind of NVP, a noncombustion and nonheating inhaler type of smokeless tobacco product (NCIT) used under 31-day confinement, were pooled, and the differences in 15 BoPH between smokers and nonsmokers at baseline and between the 1 mg tar CC (CC1) group and NCIT group at Day 28/29 were analyzed. Results: At baseline, the levels of eight BoPH (red blood cells, white blood cells, 8-epi-prostaglandin F2α, 8-hydroxy-2'-deoxyguanosine, malondialdehyde, 11-dehydrothromboxane B2, total cholesterol and glucose) were significantly different between smokers and nonsmokers. At Day 28/29, the levels of six BoPH were significantly different between NCIT and CC1 (8-epi-prostaglandin F2α, malondialdehyde, 11-dehydrothromboxane B2: CC1 > NCIT, total bilirubin, low-density lipoprotein cholesterol and total cholesterol: CC1 < NCIT). Conclusions: Reduced exposure to CSTs has favorable effects on BoPH associated with oxidative stress, antioxidant capacity and platelet activation/coagulation but not in lipid metabolism.
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Affiliation(s)
- Chikako Sakaguchi
- a Scientific and Regulatory Affairs , Japan Tobacco Inc , Tokyo , Japan
| | - Naoki Miura
- a Scientific and Regulatory Affairs , Japan Tobacco Inc , Tokyo , Japan
| | - Hiromi Ohara
- b R&D group , Japan Tobacco Inc , Yokohama , Japan
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Jain V, Ghosh RK, Bandyopadhyay D, Kondapaneni M, Mondal S, Hajra A, Aronow WS, Lavie CJ. Serum Bilirubin and Coronary Artery Disease: Intricate Relationship, Pathophysiology, and Recent Evidence. Curr Probl Cardiol 2019; 46:100431. [PMID: 31350011 DOI: 10.1016/j.cpcardiol.2019.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 06/06/2019] [Indexed: 12/21/2022]
Abstract
Coronary artery disease (CAD) is a major cause of morbidity, mortality, and healthcare expenditure. A number of environmental and genetic risk factors have been known to contribute to CAD. More recently, a number of studies have supported as well as opposed a possible protective benefit of bilirubin in CAD, since it has anti-inflammatory, antioxidant, and antiaggregatory properties that may reduce atherogenesis. It also shares associations with different forms of CAD, namely stable CAD, unstable angina pectoris, stable angina pectoris, and acute myocardial infarction. Lack of sufficient evidence, however, has failed to elucidate a causal relationship between serum bilirubin level and risk of CAD. Therefore, in this update, we attempted to simplify this intricate relationship between bilirubin and CAD, revisit the pathophysiology of disease, how bilirubin may be protective, and to summarize the findings of the current literature.
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Yang M, Ni C, Chang B, Jiang Z, Zhu Y, Tang Y, Li Z, Li C, Li B. Association between serum total bilirubin levels and the risk of type 2 diabetes mellitus. Diabetes Res Clin Pract 2019; 152:23-28. [PMID: 31078667 DOI: 10.1016/j.diabres.2019.04.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 04/11/2019] [Accepted: 04/30/2019] [Indexed: 01/19/2023]
Abstract
AIM To confirm whether serum bilirubin is an independent risk factor of type 2 diabetes mellitus (T2DM) onset in patients with impaired fasting glycemia (IFG) and impaired glucose tolerance (IGT). METHODS This was a prospective cohort study carried out at the Diabetic Identification Center of Tianjin Metabolic Diseases Hospital. Serum total bilirubin (TBIL) was measured at baseline and the patients were grouped according to baseline bilirubin quartiles. The outcome was the confirmation of T2DM by oral glucose tolerance test (OGTT) during the 3-year follow-up. Logistic regression was used to determine the risk factors for T2DM development and whether bilirubin levels are independently associated with T2DM development. RESULTS Finally, 523 patients were analyzed. After 3 years, 310 participants were diagnosed with diabetes based on OGTT. Baseline quartiles of total bilirubin were inversely associated with diabetes risk, even after multivariable adjustment. The adjusted ORs for diabetes were 1.0 (reference), 0.83 (95% CI 0.74-0.96), 0.78 (95% CI 0.68-0.90), 0.74 (95% CI 0.64-0.87) for the 1st, 2nd, 3rd, and 4th quartiles of baseline serum total bilirubin, respectively (P < 0.001). CONCLUSION In patients with IFG or IGT, low levels of serum total bilirubin were associated with a significantly increased risk of T2DM.
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Affiliation(s)
- Min Yang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China.
| | - Changlin Ni
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Baocheng Chang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Zhenhuan Jiang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Yanjuan Zhu
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Yunzhao Tang
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Zhu Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Chenguang Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
| | - Bin Li
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Medical University Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin 300070, China
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Kawamoto R, Kikuchi A, Akase T, Ninomiya D, Kasai Y, Ohtsuka N, Kumagi T. Total bilirubin independently predicts incident metabolic syndrome among community-dwelling women. Diabetes Metab Syndr 2019; 13:1329-1334. [PMID: 31336487 DOI: 10.1016/j.dsx.2019.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 02/04/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is related to the increased risk of major cardiovascular diseases (CVD). The link between high serum total bilirubin (TBL) is cross-sectionally related to MetS and its components. However, whether serum TBL predicts incidence of MetS and its components remains inconclusive. METHODS The present study included 893 women aged 70 ± 9 years from a rural village. We examined the relationship between serum TBL and MetS based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report in a cross-sectional (N = 893) and cohort (N = 288) data. RESULTS In the cross-sectional study, serum TBL (β = 0.536, p < 0.001) as well as age, alcohol consumption, exercise habits, history of CVD, SUA, GGT, and ALT was significantly and dependently associated with number of MetS components, but in the cohort study serum TBL was not associated with number of MetS components. Compared with the 1st tertile of serum TBL (0.20-0.55 mg/dL), multivariate-adjusted odds ratio (95% confidence interval) for the 2nd -3rd tertiles of serum TBL (0.54-2.00 mg/dL) was 0.70 (0.51-0.95) in the cross-sectional study and 0.41 (0.21-0.81) in the cohort study. CONCLUSIONS Our data demonstrated an independently negative association between serum TBL and MetS in Japanese community-dwelling women.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Community Medicine, Ehime University Graduate School of Medicine, Japan; Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Japan.
| | - Asuka Kikuchi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Japan; Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Japan.
| | - Taichi Akase
- Department of Community Medicine, Ehime University Graduate School of Medicine, Japan; Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Japan.
| | - Daisuke Ninomiya
- Department of Community Medicine, Ehime University Graduate School of Medicine, Japan; Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Japan.
| | - Yoshihisa Kasai
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Japan.
| | - Nobuyuki Ohtsuka
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Japan.
| | - Teru Kumagi
- Department of Community Medicine, Ehime University Graduate School of Medicine, Japan.
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Zhang L, Zhang C, Meng Z, Gong L, Pang C, Liu X, Zhang Q, Jia Q, Song K. Serum bilirubin is negatively associated with white blood cell count. Clinics (Sao Paulo) 2019; 74:e775. [PMID: 31389474 PMCID: PMC6662249 DOI: 10.6061/clinics/2019/e775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Accepted: 04/03/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Bilirubin is considered an important antioxidant, anti-inflammatory factor and immunomodulator. The current investigation aimed to explore the association between bilirubin and white blood cell (WBC) count in a large Chinese cohort. METHODS A total of 61091 participants (29259 males, 31832 females) were recruited from a Chinese tertiary hospital. Data were sorted by sex, and the association between bilirubin and WBC count was analyzed after dividing bilirubin levels into quartiles. RESULTS Most parameters (including age, body mass index, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, total bilirubin, blood urea nitrogen, creatinine, uric acid, triglycerides and WBC count) were significantly higher in men than in women. Bilirubin displayed significant negative relationships with most other measured variables. Linear logistic regression analysis further indicated their negative relationships. Females showed a significantly higher frequency of leucopenia than males. Significant associations of leucopenia with high bilirubin quartiles were shown in binary logistic regression models for both sexes, with a much closer association in men than in women. For instance, for men with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.600-times higher than that of men with values in quartile 1. For women with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.135-times higher than that of women with values in quartile 1. CONCLUSION Bilirubin is negatively related to WBC count. Significant associations exist between leucopenia and high bilirubin quartiles, and these associations are more obvious in men than in women.
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Affiliation(s)
- Li Zhang
- Department of Infectious Diseases, Tianjin Medical University General Hospital, Tianjin, P.R. China
- *Corresponding author. E-mail: /
| | - Chunmei Zhang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China
- *Corresponding author. E-mail: /
| | - Zhaowei Meng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China
- *Corresponding author. E-mail: /
| | - Lu Gong
- Department of Infectious Diseases, Tianjin Medical University General Hospital, Tianjin, P.R. China
| | - Chongjie Pang
- Department of Infectious Diseases, Tianjin Medical University General Hospital, Tianjin, P.R. China
| | - Xiangxiang Liu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, P.R. China
| | - Qing Zhang
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P.R. China
| | - Qiyu Jia
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P.R. China
| | - Kun Song
- Department of Health Management, Tianjin Medical University General Hospital, Tianjin, P.R. China
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Shiraishi M, Tanaka M, Okada H, Hashimoto Y, Nakagawa S, Kumagai M, Yamamoto T, Nishimura H, Oda Y, Fukui M. Potential impact of the joint association of total bilirubin and gamma-glutamyltransferase with metabolic syndrome. Diabetol Metab Syndr 2019; 11:12. [PMID: 30740147 PMCID: PMC6360758 DOI: 10.1186/s13098-019-0408-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 01/31/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Metabolic syndrome is characterized by the clustering of different metabolic abnormalities. Total bilirubin and gamma-glutamyltransferase (GGT) levels have been reported to be associated with this condition. However, the extent to which the interaction between these parameters affects metabolic syndrome is unknown. Therefore, we examined the association of total bilirubin and GGT levels with metabolic syndrome, and investigated the combined effect of the two parameters. METHODS In this retrospective cohort study, we analyzed 8992 middle-aged Japanese subjects (4586 men, 4406 women; mean age, 44.8 ± 9.3 years) without metabolic syndrome from a cohort of employees undergoing annual health examinations. They were divided into four groups according to median total bilirubin and GGT levels: both-low, GGT-high, total bilirubin-high, and both-high. The incident of metabolic syndrome was evaluated during a follow-up of 2.8 ± 1.2 years. RESULTS The incident rate of metabolic syndrome during the follow-up was 4.6% in the both-low group, 12.1% in the GGT-high group, 2.7% in the total bilirubin-high group, and 10.6% in the both-high group. Total bilirubin and GGT have an interaction effect on the risk of incident metabolic syndrome (p = 0.0222). The both-low [hazard ratio (HR), 1.37; 95% confidence interval (CI) 1.002-1.89], GGT-high (HR, 1.88; 95% CI 1.42-2.52), and both-high (HR, 2.07; 95% CI 1.56-2.80) groups showed an increased adjusted HR for incident metabolic syndrome after adjusting for covariates compared with the total bilirubin-high group. CONCLUSIONS The simultaneous presence of high total bilirubin and low GGT levels may be associated with a lower incidence of metabolic syndrome.
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Affiliation(s)
- Makoto Shiraishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | - Muhei Tanaka
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | - Hiroshi Okada
- Department of Internal Medicine, Matsushita Memorial Hospital, Osaka, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | | | - Muneaki Kumagai
- Medical Corporation Soukenkai, Nishimura Clinic, Kyoto, Japan
| | | | | | - Yohei Oda
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566 Japan
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Chen SC, Lin CP, Hsu HC, Shu JH, Liang Y, Hsu PF, Wang YJ, Ding YZ, Liou TL, Wang YW, Chang YC, Chan WL, Chen JW, Lin SJ, Leu HB. Serum bilirubin improves the risk predictions of cardiovascular and total death in diabetic patients. Clin Chim Acta 2019; 488:1-6. [DOI: 10.1016/j.cca.2018.10.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/25/2018] [Accepted: 10/21/2018] [Indexed: 12/30/2022]
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Nishimura T, Tanaka M, Saisho Y, Miyakoshi K, Tanaka M, Itoh H. Lower serum total bilirubin concentration is associated with higher prevalence of gestational diabetes mellitus in Japanese pregnant women. Endocr J 2018; 65:1199-1208. [PMID: 30305483 DOI: 10.1507/endocrj.ej17-0533] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We aimed to clarify the pathophysiological significance of total bilirubin (TB) in gestational diabetes mellitus (GDM). This was a cross-sectional study that included 616 pregnant Japanese women (368 normal glucose tolerance [NGT] and 248 GDM). Serum TB concentration, homeostasis model assessment of insulin resistance (HOMA-IR), and other clinical parameters were compared in NGT and GDM women. TB concentration was also compared according to the number of abnormal OGTT values. Logistic regression analysis was used to evaluate the association between TB and GDM prevalence. A multiple linear regression model was used to evaluate the association between TB and HOMA-IR. TB concentrations were significantly lower in GDM women than in NGT women. This result did not change after adjustments for TB sampling timing were made. Out of 248 GDM women, the prevalences of 1- and 2/3- abnormal OGTT values (1- and 2/3-AV) GDM were 72.2% (n = 179) and 27.8% (n = 69), respectively. In the multiple comparisons, TB concentrations were significantly lower in women with 2/3-AV GDM than in women with NGT and 1-AV GDM. Multiple logistic regression analysis showed that TB was a significantly associated factor for 2/3-AV, but not for total GDM. HOMA-IR was significantly higher in GDM women than in NGT women. The univariate, but not multivariate, analysis showed that TB was a significantly associated factor for HOMA-IR. Our findings suggest that hypobilirubinemia may be involved in the pathogenesis of GDM.
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Affiliation(s)
- Takeshi Nishimura
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masami Tanaka
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yoshifumi Saisho
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kei Miyakoshi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Mamoru Tanaka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Hiroshi Itoh
- Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
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Mao L, He J, Gao X, Guo H, Wang K, Zhang X, Yang W, Zhang J, Li S, Hu Y, Mu L, Yan Y, Ma J, Ding Y, Zhang M, Liu J, Ma R, Guo S. Metabolic syndrome in Xinjiang Kazakhs and construction of a risk prediction model for cardiovascular disease risk. PLoS One 2018; 13:e0202665. [PMID: 30188929 PMCID: PMC6126809 DOI: 10.1371/journal.pone.0202665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/07/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The high prevalence of metabolic syndrome (MetS) and cardiovascular diseases (CVD) is observed among Kazakhs in Xinjiang. Because MetS may significantly predict the occurrence of CVD, the inclusion of CVD-related indicators in metabolic network may improve the predictive ability for a CVD-risk model for Kazakhs in Xinjiang. METHODS The study included 2,644 subjects who were followed for 5 years or longer. CVD cases were identified via medical records of the local hospitals from April 2016 to August 2017. Factor analysis was performed in 706 subjects (267 men and 439 women) with MetS to extract CVD-related potential factors from 18 biomarkers tested in a routine health check-up, served as a synthetic predictor (SP). We evaluated the predictive ability of the CVD-risk model using age and SP, logistic regression discrimination for internal validation (n = 384; men = 164, women = 220) and external validation (n = 219; men = 89, women = 130), calculated the probability of CVD for each participant, and receiver operating characteristic curves. RESULTS According to the diagnostic criteria of JIS, the prevalence of MetS in Kazakh was 30.9%. Seven potential factors with a similar pattern were obtained from men and women and comprised the CVD predictors. When predicting CVD in the internal validation, the area under the curve (AUC) were 0.857 (95%CI 0.807-0.898) for men and 0.852 (95%CI 0.809-0.889) for women, respectively. In the external validation, the AUC to predict CVD were 0.914 (95%CI 0.832-0.963) for men and 0.848 (95%CI 0.774-0.905) for women. It is suggested that SP might serve as a useful tool in identifying CVD with in Kazakhs, especially for Kazakhs men. CONCLUSIONS Among 7 potential factors were extracted from 18 biomarkrs in Kazakhs with MetS, and SP may be used for CVD risk assessment.
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Affiliation(s)
- Lei Mao
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Jia He
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Xiang Gao
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, United States of America
| | - Heng Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Kui Wang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Xianghui Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Wenwen Yang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Jingyu Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Shugang Li
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Yunhua Hu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Lati Mu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Yizhong Yan
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Jiaolong Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Yusong Ding
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Mei Zhang
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Jiaming Liu
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Rulin Ma
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
| | - Shuxia Guo
- Department of Public Health, Shihezi University School of Medicine, Shihezi, Xinjiang, China
- Department of Pathology and Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), Shihezi University School of Medicine, Shihezi, Xinjiang, China
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Fujiwara R, Haag M, Schaeffeler E, Nies AT, Zanger UM, Schwab M. Systemic regulation of bilirubin homeostasis: Potential benefits of hyperbilirubinemia. Hepatology 2018; 67:1609-1619. [PMID: 29059457 DOI: 10.1002/hep.29599] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 09/11/2017] [Accepted: 10/13/2017] [Indexed: 12/17/2022]
Abstract
Neurotoxic bilirubin is the end product of heme catabolism in mammals. Bilirubin is solely conjugated by uridine diphospho-glucuronosyltransferase 1A1, which is a membrane-bound enzyme that catalyzes the transfer of glucuronic acid. Due to low function of hepatic and intestinal uridine diphospho-glucuronosyltransferase 1A1 during the neonatal period, human neonates develop mild to severe physiological hyperbilirubinemia. Accumulation of bilirubin in the brain leads to the onset of irreversible brain damage, termed kernicterus. Breastfeeding is one of the most significant factors that increase the risk of developing kernicterus in infants. Why does this most natural way of feeding increase the risk of brain damage or even death? This question leads to the hypothesis that breast milk-induced hyperbilirubinemia might bring certain benefits that outweigh those risks. While bilirubin is neurotoxic and cytotoxic, this compound is also a potent antioxidant. There are studies showing improved clinical conditions in patients with hyperbilirubinemia. Accumulating evidence also shows that genetic polymorphisms linked to hyperbilirubinemia are beneficial against various diseases. In this review article, we first introduce the production, metabolism, and transport of bilirubin. We then discuss the potential benefits of neonatal and adult hyperbilirubinemia. Finally, epigenetic factors as well as metabolomic information associated with hyperbilirubinemia are described. This review article advances the understanding of the physiological importance of the paradoxical compound bilirubin. (Hepatology 2018;67:1609-1619).
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Affiliation(s)
- Ryoichi Fujiwara
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,Department of Pharmacy and Biochemistry, University of Tuebingen, Tuebingen, Germany.,Department of Pharmaceutics, School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Mathias Haag
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | - Elke Schaeffeler
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | - Anne T Nies
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | - Ulrich M Zanger
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,University of Tuebingen, Tuebingen, Germany
| | - Matthias Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,Department of Pharmacy and Biochemistry, University of Tuebingen, Tuebingen, Germany.,Department of Clinical Pharmacology, University Hospital, Tuebingen, Germany.,German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
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Abstract
PURPOSE OF REVIEW This review aims to highlight recent advances on the role of hyperbilirubinemia in hypertension and chronic kidney disease, with a focus on the pathophysiological mechanisms explaining the protective effects of bilirubin. An overview of pharmacologic induction of hyperbilirubinemia will also be discussed. RECENT FINDINGS The findings depict a protective role of bilirubin in the development of hypertension and cardiovascular diseases. Hyperbilirubinemia is also negatively correlated with the development and progression of chronic kidney disease. Commonly used drugs play a role in pharmacologic induction of hyperbilirubinemia. Bilirubin is therefore an exciting target for new therapeutic interventions for its antioxidant properties can be pivotal in the management of hypertension and in preventing and halting the progression of chronic kidney disease. Longitudinal studies are warranted to evaluate the prospective association between bilirubin levels and incident hypertension and chronic kidney disease in the general population. Interventions to induce hyperbilirubinemia need to be explored as a novel therapeutic approach in fighting disease burden.
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Affiliation(s)
- Ibrahim Mortada
- American University of Beirut Faculty of Medicine, Beirut, Lebanon.
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Bereczki D, Balla J, Bereczki D. Heme Oxygenase-1: Clinical Relevance in Ischemic Stroke. Curr Pharm Des 2018; 24:2229-2235. [PMID: 30014798 PMCID: PMC6302555 DOI: 10.2174/1381612824666180717101104] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/02/2018] [Accepted: 07/12/2018] [Indexed: 02/07/2023]
Abstract
Stroke is the second-leading cause of death and a leading cause of serious long-term disability worldwide, with an increasing global burden due to the growing and aging population. However, strict eligibility criteria for current treatment opportunities make novel therapeutic approaches desirable. Oxidative stress plays a pivotal role during cerebral ischemia, eventually leading to neuronal injury and cell death. The significant correlation between redox imbalance and ischemic stroke has led to various treatment strategies targeting the endogenous antioxidant system in order to ameliorate the adverse prognosis in patients with cerebral infarction. One of the most extensively investigated cellular defense pathway in this regard is the Nrf2-heme oxygenase-1 (HO-1) axis. In this review, our aim is to focus on the potential clinical relevance of targeting the HO-1 pathway in ischemic stroke.
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Affiliation(s)
- Daniel Bereczki
- Address correspondence to this author at the Department of Neurology, Medical Centre, Hungarian Defence Forces, Róbert Károly krt. 44., Budapest, H-1134, Hungary; Tel: +36-70-701-0671; E-mail:
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Ozeki M, Morita H, Miyamura M, Fujisaka T, Fujita SI, Ito T, Shibata K, Tanaka S, Sohmiya K, Hoshiga M, Ishizaka N. High serum bilirubin is associated with lower prevalence of peripheral arterial disease among cardiac patients. Clin Chim Acta 2018; 476:60-66. [DOI: 10.1016/j.cca.2017.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/14/2017] [Accepted: 11/14/2017] [Indexed: 10/18/2022]
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Chmielewski P, Strzelec B, Chmielowiec J, Chmielowiec K, Borysławski K. Association of serum bilirubin with longevity: Evidence from a retrospective longitudinal study and cross-sectional data. ANTHROPOLOGICAL REVIEW 2017. [DOI: 10.1515/anre-2017-0024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Abstract
Bilirubin is a potent antioxidant and an important anti-inflammatory factor. Therefore, there has been an increasing focus on serum bilirubin as a negative risk factor of cardiovascular mortality in men and an indicator of improved survival in both sexes, but the direct mechanisms of these links and the causes of sex differences are not well understood. Moreover, the evidence from longitudinal studies on effects of bilirubin on longevity is limited. In this study, we retrospectively analyzed two groups of older adults to explore age-dependent changes in serum bilirubin levels and their associations with long-term survival in both sexes. Longitudinal data from 142 individuals (68 men and 74 women) aged 45 to 70 years were compared with cross-sectional data from 225 individuals (113 men and 112 women). The latter group was divided into four categories of survival, i.e. 53, 63, 68, and 76+ based on data on lifespan. ANOVA, t-test, and regression analysis were run. The analysis of the longitudinal data showed an increase in serum total bilirubin levels in men (0.3038e0.093x, R2 = 0.667) and women (0.1838e0.0187x, R2 = 0.950), while the analysis of cross-sectional data revealed a U-shaped pattern of age-related changes in men (0.001x2 - 0.1263x + 4.4524, R2 = 0.999) but an inverted U-shaped pattern in women (0.0006x2 + 0.072x - 1.6924, R2 = 0.195). On balance, these results suggest that elevated but normal bilirubin levels might confer a survival advantage in older men but not women. Alternatively, the positive relationship between serum total bilirubin and lifespan was not causal but coincidental. Further studies are needed to elucidate the direct mechanisms of the association between serum bilirubin levels and longevity in elderly people of both sexes.
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Affiliation(s)
- Piotr Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Poland
| | - Bartłomiej Strzelec
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Poland
- Department and Clinic of Gastrointestinal and General Surgery, Wroclaw Medical University, Poland
| | - Jolanta Chmielowiec
- Faculty of Medicine and Health Sciences, The University of Zielona Gora , Poland
| | | | - Krzysztof Borysławski
- Department of Anthropology, Wroclaw University of Environmental and Life Sciences, Poland
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Direct Bilirubin Levels and Risk of Metabolic Syndrome in Healthy Chinese Men. BIOMED RESEARCH INTERNATIONAL 2017; 2017:9621615. [PMID: 29423413 PMCID: PMC5750483 DOI: 10.1155/2017/9621615] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/13/2017] [Accepted: 11/27/2017] [Indexed: 01/04/2023]
Abstract
Background Serum bilirubin is a potent endogenous antioxidant with anti-inflammatory properties. Several cross-sectional studies have reported that bilirubin was negatively associated with metabolic syndrome. However, in recent longitudinal studies, the relations between bilirubin and metabolic syndrome are inconsistent. Moreover, previous studies mainly focused on serum total bilirubin which is the sum of direct bilirubin and indirect bilirubin. For these reasons, the longitudinal effect of bilirubin subtypes on incident metabolic syndrome was evaluated in Chinese men. Methods The study cohort involved 1339 Chinese men without metabolic syndrome. Metabolic syndrome was defined by the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) criteria, using BMI for the replacement of waist circumference. Results There are 117 incident metabolic syndrome cases (8.7%) during 5 years of follow-up among 1339 metabolic syndrome-free participants at baseline. After adjusting for age, drinking, smoking, physical activity, TG, and LDL-C, the odd ratios (ORs) and 95% confidence intervals (CIs) for MetS incidence in the second, third, and fourth quartiles versus the first quartile of DBil concentration were 1.00 (0.61-1.63), 0.57 (0.32-1.02), and 0.51 (0.28-0.92) (Ptrend = 0.031), respectively. Conclusions Our findings support the negative association between direct bilirubin and incident metabolic syndrome in healthy Chinese men over 5-year period.
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Kawamoto R, Ninomiya D, Senzaki K, Kumagi T. Alanine Aminotransferase and Total Bilirubin Are Synergistically Associated with Metabolic Syndrome Among Middle-Aged and Elderly Japanese Women. Metab Syndr Relat Disord 2017; 15:407-415. [PMID: 28922061 DOI: 10.1089/met.2017.0064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is associated with an increased risk of major cardiovascular events. Alanine aminotransferase (ALT) at high levels and total bilirubin (T-BiL) at low levels were oxidative potentials, but it was uncertain whether ALT and T-BiL had an additive interaction for the risk of MetS. METHODS From a single community, we recruited 864 women (70 ± 8 years) during their annual health examination. We cross-sectionally investigated whether ALT and T-BiL are associated with MetS and its components based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report. RESULTS Of these subjects, 415 women (48.0%) had MetS. Participants with MetS had a higher ALT and lower T-BiL level than those without MetS. The adjusted-odds ratios (OR) (95% confidence interval [CI]) for MetS across tertiles of ALT and T-BiL were 1.00, 1.19 (0.78-1.81), and 1.86 (1.24-2.80) and 1.00, 0.96 (0.65-1.43), and 0.54 (0.36-0.81), respectively. When ALT and T-BiL were categorized into three binary characteristics by tertiles of ALT and T-BiL, high T-BiL was associated with decreased risk for MetS in a multivariable model (OR: 0.55, 95% CI: 0.37-0.82), especially among those with 1st tertile ALT. Similarly, high ALT was also associated with increased risk for MetS in a multivariate model (OR: 1.81, 95% CI: 1.20-2.71), especially among those with 2nd & 3rd tertiles of T-BiL. In the formal testing of addictive interaction between ALT and T-BiL for MetS, presence of T-BiL <0.72 mg/dL (1st and 2nd tertile) alone was not associated with increased risk of MetS in a multivariate analysis, and presence of ALT ≥16 IU/L (2nd and 3rd tertile) alone was not associated with increased risk of MetS. CONCLUSIONS These results suggested that higher ALT and lower T-BiL levels were synergistically associated with MetS, independent of other confounding factors among Japanese women.
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Affiliation(s)
- Ryuichi Kawamoto
- 1 Department of Community Medicine, Ehime University Graduate School of Medicine , Ehime, Japan .,2 Department of Internal Medicine, Seiyo Municipal Nomura Hospital , Ehime, Japan
| | - Daisuke Ninomiya
- 1 Department of Community Medicine, Ehime University Graduate School of Medicine , Ehime, Japan
| | - Kensuke Senzaki
- 1 Department of Community Medicine, Ehime University Graduate School of Medicine , Ehime, Japan
| | - Teru Kumagi
- 1 Department of Community Medicine, Ehime University Graduate School of Medicine , Ehime, Japan
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Fujiwara R, Mitsugi R, Uemura A, Itoh T, Tukey RH. Severe Neonatal Hyperbilirubinemia in Crigler-Najjar Syndrome Model Mice Can Be Reversed With Zinc Protoporphyrin. Hepatol Commun 2017; 1:792-802. [PMID: 29399656 PMCID: PMC5678921 DOI: 10.1002/hep4.1082] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Neurotoxic bilirubin is solely conjugated by UDP-glucuronosyltransferase (UGT) 1A1. Due to an inadequate function of UGT1A1, human neonates develop mild to severe physiological hyperbilirubinemia. Accumulation of bilirubin in the brain leads to the onset of irreversible brain damage called kernicterus. Breastfeeding is one of the most significant factors that increase the risk of developing kernicterus in infants. Why does the most natural way of feeding increase the risk of brain damage or even death? This question leads to the hypothesis that breast milk-induced neonatal hyperbilirubinemia might bring certain benefits to the body. One of the barriers to answering the above question is the lack of animal models that display mild to severe neonatal hyperbilirubinemia. A mouse model that develops neonatal hyperbilirubinemia was previously developed by a knockout of the Ugt1 locus. Deletion of Ugt1a1 results in neonatal lethality from bilirubin neurotoxicity. Bilirubin is the end product of heme catabolism in which heme oxygenase-I is largely involved. When zinc protoporphyrin, an inhibitor of heme oxygenase I, was administered to newborn Ugt1-/- mice, serum bilirubin levels dropped dramatically, rescuing the mice from bilirubin-induced neonatal lethality. Zinc protoporphyrin-treated Ugt1-/- mice developed normally as adults capable of reproducing, but their newborns showed even more severe hyperbilirubinemia. Microarray analysis of the hyperbilirubinemic livers indicated that a number of genes associated with nucleotide, transport, and immune response were significantly down-regulated in a serum bilirubin level-dependent manner. Conclusion: Our study provides an opportunity to advance the development of effective therapeutics to effectively and rapidly prevent bilirubin-induced toxicity. Neonatal hyperbilirubinemia has various impacts on the body that could be driven by the antioxidant property of bilirubin.
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Affiliation(s)
- Ryoichi Fujiwara
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany.,Department of Biochemistry and Pharmacy, University of Tubingen, Tubingen, Germany.,Department of Pharmaceutics, School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Ryo Mitsugi
- Department of Pharmaceutics, School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Asuka Uemura
- Department of Pharmaceutics, School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Tomoo Itoh
- Department of Pharmaceutics, School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Robert H Tukey
- Laboratory of Environmental Toxicology, Department of Pharmacology, University of California San Diego, La Jolla, CA
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Karadag F, Sengul CB, Enli Y, Karakulah K, Alacam H, Kaptanoglu B, Kalkanci O, Herken H. Relationship between Serum Bilirubin Levels and Metabolic Syndrome in Patients with Schizophrenia Spectrum Disorders. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2017; 15:153-162. [PMID: 28449563 PMCID: PMC5426494 DOI: 10.9758/cpn.2017.15.2.153] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/16/2016] [Accepted: 06/22/2016] [Indexed: 12/24/2022]
Abstract
Objective We investigated the relationship between serum bilirubin levels and metabolic syndrome (MetS), and the longitudinal effects of baseline serum bilirubin concentrations on MetS in patients with schizophrenia spectrum disorders undergoing atypical antipsychotics. Methods The sample of this study consisted of 131 patients with schizophrenia spectrum disorders. Waist circumference, blood pressure, and levels of triglycerides, high-density lipoprotein cholesterol, fasting glucose, and insulin were evaluated at baseline and at month six. Serum bilirubin levels were measured at baseline. Serum bilirubin levels of the patients with and without MetS criteria were compared. We also compared patients with high and low bilirubin levels (upper and lower 50th percentiles of serum bilirubin levels) in terms of MetS criteria, MetS frequency, and course of MetS. Results Serum direct bilirubin levels were more consistently related to MetS and MetS-related variables. The waist circumference and triglyceride criteria for MetS were significantly related to low serum direct bilirubin at baseline; waist circumference and fasting glucose criteria, and insulin resistance were associated with low serum direct bilirubin at follow-up. MetS diagnosis and the presence of the waist circumference criterion were more frequent at the baseline and the follow-up in low bilirubin group. At the end of the follow-up period, the rate of reverse MetS was significantly higher in the high bilirubin group. Conclusion Our results have suggested that serum direct bilirubin levels showed a more reliable and stable relationship with abdominal obesity for MetS components.in patients with schizophrenia spectrum disorders using antipsychotics. Further studies are required.
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Affiliation(s)
- Filiz Karadag
- Department of Psychiatry, Gazi University Medical Faculty, Ankara, Turkey
| | - Ceyhan Balci Sengul
- Department of Psychiatry, Pamukkale University Medical Faculty, Denizli, Turkey
| | - Yasar Enli
- Department of Biochemistry, Pamukkale University Medical Faculty, Denizli, Turkey
| | - Kamuran Karakulah
- Department of Psychiatry, Tokat Dr. Cevdet Aykan Mental Health Hospital, Tokat, Turkey
| | - Huseyin Alacam
- Department of Psychiatry, Pamukkale University Medical Faculty, Denizli, Turkey
| | - Bunyamin Kaptanoglu
- Department of Biochemistry, Fatih University Medical Faculty, Istanbul, Turkey
| | - Ozgur Kalkanci
- Department of Psychiatry, Denizli State Hospital, Denizli, Turkey
| | - Hasan Herken
- Department of Psychiatry, Pamukkale University Medical Faculty, Denizli, Turkey
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48
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Relationship between serum bilirubin concentrations and diabetic nephropathy in Shanghai Han's patients with type 1 diabetes mellitus. BMC Nephrol 2017; 18:114. [PMID: 28363276 PMCID: PMC5376273 DOI: 10.1186/s12882-017-0531-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 03/24/2017] [Indexed: 12/16/2022] Open
Abstract
Background Recent studies highlight a negative association between total bilirubin concentrations and albuminuria in patients with type 2 diabetes mellitus. Our study evaluated the relationship between bilirubin concentrations and the prevalence of diabetic nephropathy (DN) in Chinese patients with type 1 diabetes mellitus (T1DM). Methods A total of 258 patients with T1DM were recruited and bilirubin concentrations were compared between patients with or without diabetic nephropathy. Multiple stepwise regression analysis was used to examine the relationship between bilirubin concentrations and 24 h urinary microalbumin. Binary logistic regression analysis was performed to assess independent risk factors for diabetic nephropathy. Participants were divided into four groups according to the quartile of total bilirubin concentrations (Q1, 0.20–0.60; Q2, 0.60–0.80; Q3, 0.80–1.00; Q4, 1.00–1.90 mg/dL) and the chi-square test was used to compare the prevalence of DN in patients with T1DM. Results The median bilirubin level was 0.56 (interquartile: 0.43–0.68 mg/dL) in the DN group, significantly lower than in the non-DN group (0.70 [interquartile: 0.58–0.89 mg/dL], P < 0.001). Spearman’s correlational analysis showed bilirubin concentrations were inversely correlated with 24 h urinary microalbumin (r = -0.13, P < 0.05) and multiple stepwise regression analysis showed bilirubin concentrations were independently associated with 24 h urinary microalbumin. In logistic regression analysis, bilirubin concentrations were significantly inversely associated with nephropathy. In addition, in stratified analysis, from the first to the fourth quartile group, increased bilirubin concentrations were associated with decreased prevalence of DN from 21.90% to 2.00%. Conclusion High bilirubin concentrations are independently and negatively associated with albuminuria and the prevalence of DN in patients with T1DM.
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Wang J, Li Y, Han X, Hu H, Wang F, Li X, Yang K, Yuan J, Yao P, Miao X, Wei S, Wang Y, Cheng W, Liang Y, Zhang X, Guo H, Yang H, Yuan J, Koh WP, Hu FB, Wu T, Pan A, He M. Serum bilirubin levels and risk of type 2 diabetes: results from two independent cohorts in middle-aged and elderly Chinese. Sci Rep 2017; 7:41338. [PMID: 28164994 PMCID: PMC5292699 DOI: 10.1038/srep41338] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 12/16/2016] [Indexed: 01/06/2023] Open
Abstract
Serum bilirubin is a potent endogenous antioxidant and has been identified as cardiovascular risk in cohort studies, while the relation to type 2 diabetes (T2D) in the elderly remains unclear. We investigated both cross-sectional and prospective associations between serum bilirubin levels and T2D risk in the Dongfeng-Tongji (DFTJ) cohort, and replicated the prospective findings in a nested case-control study (509 cases and 509 controls) within the Singapore Chinese Health Study (SCHS). In the cross-sectional analysis of DFTJ cohort (15,575 participants with 2,532 diabetes cases), serum bilirubin levels (total, direct and indirect) increased in new on-set diabetes and decreased with the diabetic duration. In the longitudinal analysis of DFTJ cohort (772 incident diabetes cases during 4.5 years of follow-up among 12,530 diabetes-free participants at baseline), positive association was found between direct bilirubin and T2D risk comparing extreme quartiles, similar results were observed in the nested case-control study within SCHS. Total and indirect bilirubin levels were not significantly associated with T2D in either cohort. In conclusion, our findings do not support the protective association between serum bilirubin levels and incident T2D in the middle-aged and elderly adults; instead, direct bilirubin levels were associated with increased risk of T2D.
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Affiliation(s)
- Jing Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Yaru Li
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xu Han
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hua Hu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiulou Li
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Kun Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Jing Yuan
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yao
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoping Miao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youjie Wang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weihong Cheng
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Liang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huan Guo
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Handong Yang
- Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China
| | - Jianmin Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | | | - Frank B Hu
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tangchun Wu
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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50
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Zhong P, Sun DM, Wu DH, Li TM, Liu XY, Liu HY. Serum total bilirubin levels are negatively correlated with metabolic syndrome in aged Chinese women: a community-based study. ACTA ACUST UNITED AC 2017; 50:e5252. [PMID: 28146216 PMCID: PMC5304216 DOI: 10.1590/1414-431x20165252] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 09/29/2016] [Indexed: 12/31/2022]
Abstract
We evaluated serum total bilirubin levels as a predictor for metabolic syndrome (MetS) and investigated the relationship between serum total bilirubin levels and MetS prevalence. This cross-sectional study included 1728 participants over 65 years of age from Eastern China. Anthropometric data, lifestyle information, and previous medical history were collected. We then measured serum levels of fasting blood-glucose, total cholesterol, triglycerides, and total bilirubin, as well as alanine aminotransferase activity. The prevalence of MetS and each of its individual component were calculated per quartile of total bilirubin level. Logistic regression was used to assess the correlation between serum total bilirubin levels and MetS. Total bilirubin level in the women who did not have MetS was significantly higher than in those who had MetS (P<0.001). Serum total bilirubin quartiles were linearly and negatively correlated with MetS prevalence and hypertriglyceridemia (HTG) in females (P<0.005). Logistic regression showed that serum total bilirubin was an independent predictor of MetS for females (OR: 0.910, 95%CI: 0.863-0.960; P=0.001). The present study suggests that physiological levels of serum total bilirubin might be an independent risk factor for aged Chinese women, and the prevalence of MetS and HTG are negatively correlated to serum total bilirubin levels.
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Affiliation(s)
- P Zhong
- Department of Neurology, Shanghai TCM Integrated Hospital, Shanghai University of Chinese Medicine, Shanghai, China
| | - D M Sun
- Puxing Community Health Service Centers, Pudong New Area, Shanghai, China
| | - D H Wu
- Department of Neurology, the Third People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - T M Li
- Department of Neurology, Shanghai TCM Integrated Hospital, Shanghai University of Chinese Medicine, Shanghai, China
| | - X Y Liu
- Department of Neurology, Shanghai TCM Integrated Hospital, Shanghai University of Chinese Medicine, Shanghai, China
| | - H Y Liu
- Pingliang Community Health Service Centers, Yangpu Area, Shanghai, China
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