Serum Total Bilirubin Concentration Is Inversely Correlated with Framingham Risk Score in Koreans

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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Are liver function biomarkers independently associated with Framingham risk score in women?

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh181120006k ◽

2020 ◽

Vol 148 (7-8) ◽

pp. 423-429

Author(s):

Aleksandra Klisic ◽

Nebojsa Kavaric ◽

Ana Ninic

Keyword(s):

Liver Function ◽

Risk Score ◽

Framingham Risk Score ◽

Total Bilirubin ◽

Multivariate Logistic Regression Analysis ◽

Total Bilirubin Level ◽

Gamma Glutamyl Transferase ◽

Cvd Risk ◽

Framingham Risk ◽

Glutamyl Transferase

Introduction/Objective. Given the contradictory results regarding the association of liver function biomarkers [e.g., alanine-aminotransferase (ALT), gamma-glutamyl transferase (GGT) and total bilirubin)] and the risk of cardiovascular disease (CVD), we aimed to explore the relationship between these biomarkers and Framingham risk score (FRS), an established tool used in the prediction of 10-year CVD risk in the cohort of women. Methods. A total of 278 women participated in this cross-sectional study. Anthropometric, biochemical parameters, and blood pressure were obtained. Results. There was a significant increase in ALT and GGT activity, as well as a decrease in total bilirubin level in the high-risk FRS group compared to moderate-, and low-risk FRS (p for trend = 0.025, p < 0.001, p < 0.001, respectively). Multivariate logistic regression analysis showed that body mass index, triglycerides, creatinine, and high sensitivity C-reactive protein levels were the independent predictors of FRS in women [odds ratio (OR) = 1.234, p = 0.001; OR = 2.856, p = 0.001; OR = 1.090, p = 0.002, and OR = 1.295, p = 0.045, respectively]. In contrast, total bilirubin, ALT and GGT lost their independent predictions for high CVD risk. Conclusion. Liver function biomarkers (i.e. ALT, GGT, and total bilirubin) are not independently associated with FRS. It seems that some other cardiometabolic disturbances might modulate this relationship.

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Hyperbilirubinemia in Preterm Infants and Neurodevelopmental Outcome at 2 Years of Age: Results of a National Collaborative Survey

PEDIATRICS ◽

10.1542/peds.83.6.915 ◽

1989 ◽

Vol 83 (6) ◽

pp. 915-920

Author(s):

Margot van de Bor ◽

Thea M. van Zeben-van der Aa ◽

S. Pauline Verloove-Vanhorick ◽

Ronald Brand ◽

Jan H. Ruys

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Total Bilirubin ◽

Neurodevelopmental Outcome ◽

Serum Total Bilirubin ◽

Bilirubin Concentration ◽

Total Bilirubin Concentration ◽

Consistent Increase ◽

The Relationship

As part of a prospective national survey of preterm and small for gestational age infants in the Netherlands, the relationship between maximal serum total bilirubin concentration in the neonatal period and neurodevelopmental outcome at the corrected age of 2 years was studied. Initially, 1,338 infants with a gestational age of less than 32 completed weeks and/or a birth weight of less than 1,500 g were enrolled in the study; 146 were subsequently excluded because of congenital malformations and 361 died during the study period. At the corrected age of 2 years, 831 children were available for follow-up. Children with minor and major handicaps had significantly greater maximal serum total bilirubin concentrations than children with a normal neurodevelopmental outcome (P = .02). A consistent increase in prevalence of handicaps was found for each 50-µmol/L (2.9 mg/dL) increase of maximal serum total bilirubin concentration. The handicaps consisted mainly of cerebral palsy. Logistic regression analysis involving seven suspected confounding factors (gestational age, birth weight, seizures, intracranial hemorrhage, respiratory distress syndrome, ventriculomegaly, and bronchopulmonary dysplasia) revealed that the odds ratio was 1.3. This indicates that, on a multiplicative scale, the risk of a handicap increased by 30% for each 50-µmol/L (2.9 mg/dL) increase of maximal serum total bilirubin concentration (P = .02). Further analysis treated bilirubin as a categorized exposure. A striking systematic increase was found, suggesting a causal relationship between maximal serum total bilirubin concentration and neurodevelopmental outcome.

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