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Schoissengeier V, Maqboul L, Weber D, Grune T, Bürkle A, Moreno-Villaneuva M, Franceschi C, Capri M, Bernhard J, Toussaint O, Debacq-Chainiaux F, Weinberger B, Gonos ES, Sikora E, Dollé M, Jansen E, Slagboom PE, Hervonnen A, Hurme M, Breusing N, Frank J, Bulmer AC, Wagner KH. Association between bilirubin and biomarkers of metabolic health and oxidative stress in the MARK-AGE cohort. iScience 2024; 27:110234. [PMID: 39021797 PMCID: PMC11253506 DOI: 10.1016/j.isci.2024.110234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/06/2024] [Accepted: 06/06/2024] [Indexed: 07/20/2024] Open
Abstract
Recent studies have shown that elevated concentrations of unconjugated bilirubin (UCB) may be a protective host factor against the development of noncommunicable diseases (NCDs), whereas low levels of UCB are associated with the opposite effect. The results of this European study, in which 2,489 samples were tested for their UCB concentration using high-performance liquid chromatography (HPLC) and additional data from the MARK-AGE database were used for analysis, provide further evidence that elevated UCB concentrations are linked to a lower risk of developing NCDs and may act as a predictive marker of biological aging as individuals with elevated UCB concentrations showed favorable outcomes in metabolic health and oxidative-stress-related biomarkers. These findings underline the significance of studying individuals with moderate hyperbilirubinemia and investigate UCB routinely, also in the setting of aging, since this condition affects millions of people worldwide but has been underrepresented in clinical research and practice until now.
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Affiliation(s)
- Vanessa Schoissengeier
- Department of Nutritional Sciences, University of Vienna, Vienna 1090, Austria
- Vienna Doctoral School for Pharmaceutical, Nutritional and Sport Sciences (PhaNuSpo), University of Vienna, 1090 Vienna, Austria
| | - Lina Maqboul
- Department of Nutritional Sciences, University of Vienna, Vienna 1090, Austria
| | - Daniela Weber
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), 14558 Nuthetal, Germany
- Food4Future (F4F), c/o Leibniz Institute of Vegetable and Ornamental Crops (IGZ), 14979 Grossbeeren, Germany
| | - Tilman Grune
- Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), 14558 Nuthetal, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
- German Diabetes Center (DDZ), Leibniz Center for Diabetes Research, 40225 Düsseldorf, Germany
| | - Alexander Bürkle
- Molecular Toxicology Group, Department of Biology, University of Konstanz, 78464 Konstanz, Germany
| | - Maria Moreno-Villaneuva
- Molecular Toxicology Group, Department of Biology, University of Konstanz, 78464 Konstanz, Germany
- Human Performance Research Centre, Department of Sport Science, University of Konstanz, 78464 Konstanz, Germany
| | - Claudio Franceschi
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
- Laboratory of Systems Medicine of Healthy Aging, Institute of Biology and Biomedicine and Institute of Information Technology, Mathematics and Mechanics, Department of Applied Mathematics, Lobachevsky State University, 603005 Nizhny Novgorod, Russia
| | - Miriam Capri
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
- Interdepartmental Center - Alma Mater Research Institute on Global Challenges and Climate Change - University of Bologna, 40126 Bologna, Italy
| | | | | | | | - Birgit Weinberger
- Institute for Biomedical Aging Research, Universität Innsbruck, 6020 Innsbruck, Austria
| | - Efstathios S. Gonos
- National Hellenic Research Foundation, Institute of Biology, Medicinal Chemistry and Biotechnology, 116 35 Athens, Greece
| | - Ewa Sikora
- Laboratory of the Molecular Bases of Ageing, Nencki Institute of Experimental Biology, Polish Academy of Sciences, 00-901 Warsaw, Poland
| | - Martijn Dollé
- Centre for Health Protection, National Institute for Public Health and the Environment, 3720BA Bilthoven, the Netherlands
| | - Eugène Jansen
- Centre for Health Protection, National Institute for Public Health and the Environment, 3720BA Bilthoven, the Netherlands
| | - P. Eline Slagboom
- Department of Molecular Epidemiology, Leiden University Medical Centre, 2333 ZC Leiden, the Netherlands
| | - Antti Hervonnen
- Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Mikko Hurme
- Faculty of Medicine and Health Technology, Tampere University, 33100 Tampere, Finland
| | - Nicolle Breusing
- Department of Applied Nutritional Science/Dietetics, Institute of Nutritional Medicine, University of Hohenheim, 70599 Stuttgart, Germany
| | - Jan Frank
- Department of Food Biofunctionality, University of Hohenheim, 70599 Stuttgart, Germany
| | - Andrew C. Bulmer
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast Campus, Brisbane, QLD, Australia
| | - Karl-Heinz Wagner
- Department of Nutritional Sciences, University of Vienna, Vienna 1090, Austria
- Research Platform Active Ageing, University of Vienna, Vienna 1090, Austria
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Karter AJ, Parker MM, Moffet HH, Gilliam LK. Racial and Ethnic Differences in the Association Between Mean Glucose and Hemoglobin A1c. Diabetes Technol Ther 2023; 25:697-704. [PMID: 37535058 PMCID: PMC10611955 DOI: 10.1089/dia.2023.0153] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Background: Studies have reported significantly higher hemoglobin A1c (A1C) in African American patients than in White patients with the same mean glucose, but less is known about other racial/ethnic groups. We evaluated racial/ethnic differences in the association between mean glucose, based on continuous glucose monitor (CGM) data, and A1C. Methods: Retrospective study among 1788 patients with diabetes from Kaiser Permanente Northern California (KPNC) who used CGM devices during 2016 to 2021. In this study population, there were 5264 A1C results; mean glucose was calculated from 124,388,901 CGM readings captured during the 90 days before each A1C result. Hierarchical mixed models were specified to estimate racial/ethnic differences in the association between mean glucose and A1C. Results: Mean A1C was 0.33 (95% confidence interval: 0.23-0.44; P < 0.0001) percentage points higher among African American patients relative to White patients for a given mean glucose. A1C results for Asians, Latinos, and multiethnic patients were not significantly different from those of White patients. The slope of the association between mean glucose and A1C did not differ significantly across racial/ethnic groups. Variance for the association between mean glucose and A1C was substantially greater within groups than between racial/ethnic groups (65% vs. 9%, respectively). Conclusions: For African American patients, A1C results may overestimate glycemia and could lead to premature diabetes diagnoses, overtreatment, or invalid assessments of health disparities. However, most of the variability in the mean glucose-A1C association was within racial/ethnic groups. Treatment decisions driven by guideline-based A1C targets should be individualized and supported by direct measurement of glycemia.
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Affiliation(s)
- Andrew J. Karter
- Kaiser Permanente—Division of Research, Oakland, California, USA
- Department of General Internal Medicine, University of California, San Francisco, California, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| | | | - Howard H. Moffet
- Kaiser Permanente—Division of Research, Oakland, California, USA
| | - Lisa K. Gilliam
- Kaiser Northern California Diabetes Program, Endocrinology and Internal Medicine, Kaiser Permanente, South San Francisco Medical Center, South San Francisco, California, USA
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Bilirubin and Ischemic Stroke: Rendering the Current Paradigm to Better Understand the Protective Effects of Bilirubin. Mol Neurobiol 2019; 56:5483-5496. [PMID: 30612336 DOI: 10.1007/s12035-018-1440-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/21/2018] [Indexed: 01/14/2023]
Abstract
Novel and innovative methods are critical in fostering new treatments and improving clinical outcomes in patients who suffer from ischemic stroke. Bilirubin has long been considered metabolic waste that can be harmful to the body; however, it is now becoming recognized as one of the body's most potent antioxidant, anti-inflammatory, and neuroprotective molecules. These properties facilitate bilirubin's anti-atherogenic effects to impede and prevent the formation of thrombi in ischemic stroke. These functions allow for protection from neuronal injury during an ischemic state and suggest that elevated bilirubin levels may be linked to a lower rate of morbidity and mortality. Therefore, here we discuss the pathophysiology of stroke and the molecular properties of bilirubin to better understand their beneficial relationship. We outline clinical studies looking at the relationship between serum bilirubin levels and ischemic stroke prevalence. At this time, few studies have rigorously looked at the relationship between bilirubin and ischemic stroke, whether it is positive or negative. Thus, rigorous research is needed to provide evidence supporting the current studies, expand on these studies, and facilitate their translation to bedside therapy for patients who suffer from ischemic stroke.
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