Skip to main content
Top
Published in: Heart and Vessels 1/2012

01-01-2012 | Original Article

A possible cross-sectional association of serum total bilirubin with coronary heart disease and stroke in a Japanese health screening population

Authors: Eiji Oda, Ryu Kawai

Published in: Heart and Vessels | Issue 1/2012

Login to get access

Abstract

Bilirubin is a potent antioxidant, and serum total bilirubin (TB) is reported to be negatively associated with cardiovascular disease (CVD). There has been no report on the association between TB and CVD prevalence in Japanese. The aim of the study is to examine the association between TB and CVD prevalence in a Japanese health screening population. Prevalence of CVD was studied in 3,375 Japanese men and 2,069 Japanese women. Odds ratios (ORs) of each higher quintile of TB using the lowest quintile as the reference in men and of each higher tertile of TB using the lowest tertile as the reference in women were calculated for coronary heart disease (CHD) and stroke adjusting for age, liver function tests, smoking, physical activity, and alcohol consumption. The ORs [95% confidence intervals (CIs)] for CHD and stroke of the 2nd, 3rd, 4th, and 5th quintiles of TB were 0.63 (0.37–1.07) and 0.49 (0.24–1.00), 0.45 (0.22–0.90) and 0.65 (0.28–1.51), 0.69 (0.39–1.20) and 0.37 (0.15–0.87), and 0.61 (0.34–1.09) and 0.40 (0.18–0.92), respectively in men. The ORs (95% CIs) for CHD and stroke of the 2nd and 3rd tertiles of TB were 0.63 (0.37–1.07) and 0.49 (0.24–1.00), and 0.61 (0.34–1.09) and 0.40 (0.18–0.92), respectively in women. Low TB was associated with the higher prevalence of CHD and stroke in men and with the higher prevalence of stroke in women among a Japanese health screening population.
Literature
1.
go back to reference Stocker R, Yamamoto Y, McDonagh AF, Glazer AN, Ames BN (1987) Bilirubin is an antioxidant of possible physiological importance. Science 235:1043–1046PubMedCrossRef Stocker R, Yamamoto Y, McDonagh AF, Glazer AN, Ames BN (1987) Bilirubin is an antioxidant of possible physiological importance. Science 235:1043–1046PubMedCrossRef
2.
go back to reference Wu TW, Fung KP, Yang CC (1994) Unconjugated bilirubin inhibits the oxidation of human low-density lipoprotein better than Trolox. Life Sci 54:477–481 Wu TW, Fung KP, Yang CC (1994) Unconjugated bilirubin inhibits the oxidation of human low-density lipoprotein better than Trolox. Life Sci 54:477–481
3.
go back to reference Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL (1989) Beyond cholesterol: modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med 320:915–924PubMedCrossRef Steinberg D, Parthasarathy S, Carew TE, Khoo JC, Witztum JL (1989) Beyond cholesterol: modifications of low-density lipoprotein that increase its atherogenicity. N Engl J Med 320:915–924PubMedCrossRef
4.
go back to reference Erdogan D, Gullu H, Yildirim E, Tok D, Kirbas I, Ciftci O, Baycan ST, Muderrisoglu H (2006) Low serum bilirubin levels are independently and inversely related to impaired flow-mediated vasodilation and increased carotid intima-media thickness in both men and women. Atherosclerosis 184:431–437PubMedCrossRef Erdogan D, Gullu H, Yildirim E, Tok D, Kirbas I, Ciftci O, Baycan ST, Muderrisoglu H (2006) Low serum bilirubin levels are independently and inversely related to impaired flow-mediated vasodilation and increased carotid intima-media thickness in both men and women. Atherosclerosis 184:431–437PubMedCrossRef
5.
go back to reference Tanaka M, Fukui M, Tomiyasu K, Akabame S, Nakano K, Hasegawa G, Oda Y, Nakamura N (2009) Low serum bilirubin concentration is associated with coronary artery calcification (CAC). Atherosclerosis 206:287–291PubMedCrossRef Tanaka M, Fukui M, Tomiyasu K, Akabame S, Nakano K, Hasegawa G, Oda Y, Nakamura N (2009) Low serum bilirubin concentration is associated with coronary artery calcification (CAC). Atherosclerosis 206:287–291PubMedCrossRef
6.
go back to reference Schwertner HA, Jackson WG, Tolan G (1994) Association of low serum concentration of bilirubin with increased risk of coronary artery disease. Clin Chem 40:18–23PubMed Schwertner HA, Jackson WG, Tolan G (1994) Association of low serum concentration of bilirubin with increased risk of coronary artery disease. Clin Chem 40:18–23PubMed
7.
go back to reference Breimer LH, Wannamethee G, Ebrahim S, Khoo JC, Witztum JL (1995) Serum bilirubin and risk of ischemic heart disease in middle-aged British men. Clin Chem 41:1504–1508PubMed Breimer LH, Wannamethee G, Ebrahim S, Khoo JC, Witztum JL (1995) Serum bilirubin and risk of ischemic heart disease in middle-aged British men. Clin Chem 41:1504–1508PubMed
8.
go back to reference Hopkins PN, Wu LL, Hunt SC, James BC, Vincent GM, Williams RR (1996) Higher serum bilirubin is associated with decreased risk for early familial coronary artery disease. Arterioscler Thromb Vasc Biol 16:250–255PubMedCrossRef Hopkins PN, Wu LL, Hunt SC, James BC, Vincent GM, Williams RR (1996) Higher serum bilirubin is associated with decreased risk for early familial coronary artery disease. Arterioscler Thromb Vasc Biol 16:250–255PubMedCrossRef
9.
go back to reference Troughton JA, Woodside JV, Young IS, Arveiler D, Amouyel P, Ferrières J, Ducimetière P, Patterson CC, Kee F, Yarnell JW, Evans A; PRIME Study Group (2007) Bilirubin and coronary heart disease risk in the Prospective Epidemiological Study of Myocardial Infarction (PRIME). Eur J Cardiovasc Prev Rehabil 14:79–84 Troughton JA, Woodside JV, Young IS, Arveiler D, Amouyel P, Ferrières J, Ducimetière P, Patterson CC, Kee F, Yarnell JW, Evans A; PRIME Study Group (2007) Bilirubin and coronary heart disease risk in the Prospective Epidemiological Study of Myocardial Infarction (PRIME). Eur J Cardiovasc Prev Rehabil 14:79–84
10.
go back to reference Vítek L, Jirsa M, Brodanová M, Kalab M, Marecek Z, Danzig V, Novotný L, Kotal P (2002) Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis 160:449–456PubMedCrossRef Vítek L, Jirsa M, Brodanová M, Kalab M, Marecek Z, Danzig V, Novotný L, Kotal P (2002) Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis 160:449–456PubMedCrossRef
11.
go back to reference Perlstein TS, Pande RL, Beckman JA, Creager MA (2008) Serum total bilirubin level and prevalent lower-extremity peripheral arterial disease. National Health and Nutrition Examination Survey (NHANES) 1999 to 2004. Arterioscler Thromb Vasc Biol 28:166–172PubMedCrossRef Perlstein TS, Pande RL, Beckman JA, Creager MA (2008) Serum total bilirubin level and prevalent lower-extremity peripheral arterial disease. National Health and Nutrition Examination Survey (NHANES) 1999 to 2004. Arterioscler Thromb Vasc Biol 28:166–172PubMedCrossRef
12.
go back to reference Perlstein TS, Pande RL, Creager MA, Weuve J, Beckman JA (2008) Serum total bilirubin level, prevalent stroke, and stroke outcomes: NHANES 1999–2004. Am J Med 121:781–788.e1 Perlstein TS, Pande RL, Creager MA, Weuve J, Beckman JA (2008) Serum total bilirubin level, prevalent stroke, and stroke outcomes: NHANES 1999–2004. Am J Med 121:781–788.e1
13.
go back to reference Kimm H, Yun JE, Jo J, Jee SH (2009) Low serum bilirubin level as an independent predictor of stroke incidence: a prospective study in Korean men and women. Stroke 40:3422–3427PubMedCrossRef Kimm H, Yun JE, Jo J, Jee SH (2009) Low serum bilirubin level as an independent predictor of stroke incidence: a prospective study in Korean men and women. Stroke 40:3422–3427PubMedCrossRef
14.
go back to reference Schwertner HA, Vítek L (2008) Gilbert syndrome, UGT1A1*28 allele, and cardiovascular disease risk: possible protective effects and therapeutic applications of bilirubin. Atherosclerosis 198:1–11PubMedCrossRef Schwertner HA, Vítek L (2008) Gilbert syndrome, UGT1A1*28 allele, and cardiovascular disease risk: possible protective effects and therapeutic applications of bilirubin. Atherosclerosis 198:1–11PubMedCrossRef
15.
go back to reference Ishizaka N, Ishizaka Y, Takahashi E, Yamakado M, Hashimoto H (2001) High serum bilirubin level is inversely associated with the presence of carotid plaque. Stroke 32:580–583PubMedCrossRef Ishizaka N, Ishizaka Y, Takahashi E, Yamakado M, Hashimoto H (2001) High serum bilirubin level is inversely associated with the presence of carotid plaque. Stroke 32:580–583PubMedCrossRef
16.
go back to reference Inoguchi T, Sasaki S, Kobayashi K, Takayanagi R, Yamada T (2007) Relationship between Gilbert syndrome and prevalence of vascular complications in patients with diabetes. JAMA 298:1398–1400PubMedCrossRef Inoguchi T, Sasaki S, Kobayashi K, Takayanagi R, Yamada T (2007) Relationship between Gilbert syndrome and prevalence of vascular complications in patients with diabetes. JAMA 298:1398–1400PubMedCrossRef
17.
go back to reference Temme EH, Zhang J, Schouten EG, Kesteloot H (2001) Serum bilirubin and 10-year mortality risk in a Belgian population. Cancer Causes Control 12:887–894PubMedCrossRef Temme EH, Zhang J, Schouten EG, Kesteloot H (2001) Serum bilirubin and 10-year mortality risk in a Belgian population. Cancer Causes Control 12:887–894PubMedCrossRef
18.
go back to reference Pineda S, Bang OY, Saver JL, Starkman S, Yun SW, Liebeskind DS, Kim D, Ali LK, Shah SH, Ovbiagele B (2008) Association of serum bilirubin with ischemic stroke outcomes. J Stroke Cerebrovasc Dis 17:147–152PubMedCrossRef Pineda S, Bang OY, Saver JL, Starkman S, Yun SW, Liebeskind DS, Kim D, Ali LK, Shah SH, Ovbiagele B (2008) Association of serum bilirubin with ischemic stroke outcomes. J Stroke Cerebrovasc Dis 17:147–152PubMedCrossRef
19.
go back to reference Crisby M, Kublickiene K, Henareh L, Agewall S (2009) Circulating levels of autoantibodies to oxidized low-density lipoprotein and C-reactive protein levels correlate with endothelial function in resistance arteries in men with coronary heart disease. Heart Vessels 24:90–95PubMedCrossRef Crisby M, Kublickiene K, Henareh L, Agewall S (2009) Circulating levels of autoantibodies to oxidized low-density lipoprotein and C-reactive protein levels correlate with endothelial function in resistance arteries in men with coronary heart disease. Heart Vessels 24:90–95PubMedCrossRef
20.
go back to reference Tabridou A, Efthimiadis A, Efthimiadis L, Manolopoulos VG (2010) Simvastatin-induced changes in circulating oxidized low-density lipoprotein in different types of dyslipidemia. Heart Vessels 25:288–293CrossRef Tabridou A, Efthimiadis A, Efthimiadis L, Manolopoulos VG (2010) Simvastatin-induced changes in circulating oxidized low-density lipoprotein in different types of dyslipidemia. Heart Vessels 25:288–293CrossRef
21.
go back to reference Yesilova Z, Serdar M, Ercin CN, Gunay A, Kilciler G, Hasimi A, Uygun A, Kurt I, Erbil MK, Dagalp K (2008) Decreased oxidation susceptibility of plasma low density lipoproteins in patients with Gilbert’s syndrome. J Gastroenterol Hepatol 23:1556–1560PubMedCrossRef Yesilova Z, Serdar M, Ercin CN, Gunay A, Kilciler G, Hasimi A, Uygun A, Kurt I, Erbil MK, Dagalp K (2008) Decreased oxidation susceptibility of plasma low density lipoproteins in patients with Gilbert’s syndrome. J Gastroenterol Hepatol 23:1556–1560PubMedCrossRef
22.
go back to reference Kalousová M, Novotny L, Zima T, Braun M, Vítek L (2005) Decreased levels of advanced glycation end-products in patients with Gilbert syndrome. Cell Mol Biol 51:387–392PubMed Kalousová M, Novotny L, Zima T, Braun M, Vítek L (2005) Decreased levels of advanced glycation end-products in patients with Gilbert syndrome. Cell Mol Biol 51:387–392PubMed
23.
go back to reference Gullu H, Erdogan D, Tok D, Topcu S, Caliskan M, Ulus T, Muderrisoglu H (2005) High serum bilirubin concentrations preserve coronary flow reserve and coronary microvascular functions. Arterioscler Thromb Vasc Biol 25:2289–2294PubMedCrossRef Gullu H, Erdogan D, Tok D, Topcu S, Caliskan M, Ulus T, Muderrisoglu H (2005) High serum bilirubin concentrations preserve coronary flow reserve and coronary microvascular functions. Arterioscler Thromb Vasc Biol 25:2289–2294PubMedCrossRef
24.
go back to reference Ekblom K, Marklund SL, Jansson JH, Osterman P, Hallmans G, Weinehall L, Hultdin J (2010) Plasma bilirubin and UGT1A1*28 are not protective factors against first-time myocardial infarction in a prospective, nested case-referent setting. Circ Cardiovasc Genet 3:340–347PubMedCrossRef Ekblom K, Marklund SL, Jansson JH, Osterman P, Hallmans G, Weinehall L, Hultdin J (2010) Plasma bilirubin and UGT1A1*28 are not protective factors against first-time myocardial infarction in a prospective, nested case-referent setting. Circ Cardiovasc Genet 3:340–347PubMedCrossRef
25.
go back to reference Öllinger R, Bilban M, Erat A, Froio A, McDaid J, Tyagi S, Csizmadia E, Graҫa-Souza AV, Liloia A, Soares MP, LE Otterbein, Usheva A, Yamashita K, Bach FH (2005) Bilirubin: a natural inhibitor of vascular smooth muscle cell proliferation. Circulation 112:1030–1039PubMedCrossRef Öllinger R, Bilban M, Erat A, Froio A, McDaid J, Tyagi S, Csizmadia E, Graҫa-Souza AV, Liloia A, Soares MP, LE Otterbein, Usheva A, Yamashita K, Bach FH (2005) Bilirubin: a natural inhibitor of vascular smooth muscle cell proliferation. Circulation 112:1030–1039PubMedCrossRef
26.
go back to reference Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Wu Y, Bostick RM (1996) Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 334:1156–1162PubMedCrossRef Kushi LH, Folsom AR, Prineas RJ, Mink PJ, Wu Y, Bostick RM (1996) Dietary antioxidant vitamins and death from coronary heart disease in postmenopausal women. N Engl J Med 334:1156–1162PubMedCrossRef
27.
go back to reference Kris-Etherton PM, Lichtenstein AH, Howard BV, Steinberg D, Witztum JL (2004) Antioxidant vitamin supplements and cardiovascular disease. Circulation 110:637–641PubMedCrossRef Kris-Etherton PM, Lichtenstein AH, Howard BV, Steinberg D, Witztum JL (2004) Antioxidant vitamin supplements and cardiovascular disease. Circulation 110:637–641PubMedCrossRef
Metadata
Title
A possible cross-sectional association of serum total bilirubin with coronary heart disease and stroke in a Japanese health screening population
Authors
Eiji Oda
Ryu Kawai
Publication date
01-01-2012
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 1/2012
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-011-0123-7

Other articles of this Issue 1/2012

Heart and Vessels 1/2012 Go to the issue