Abstract

Background: Inverse correlations of high serum bilirubin with metabolic and cardiovascular disease have been suggested. However, anti-atherogenic effects of bilirubin have not been well-established in terms of the presence of plaques and stenosis identified in coronary computed tomography (CT). Methods: A cross-sectional study was conducted on 2862 men who were free of cardiovascular disease and underwent coronary CT as part of a routine medical screening examination. Coronary stenotic lesions were considered to be incidences of coronary atherosclerosis, and stenosis was classified as stenosis <50% or ≥50%, according to degree of stenosis. Results: The prevalences of coronary atherosclerosis and stenosis ≥50% in subjects with elevated bilirubin levels (>1.2mg/dL) were lower than those in subjects with normal bilirubin levels (≤1.2mg/dL) (19.9% vs. 27.9%, p<0.001, 8.5% vs. 10.3%, p=0.044). Bilirubin was inversely associated with total plaques (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.48-0.73 in the 4th quartile vs. 1st quartile) and calcified plaques (OR 0.60, 95% CI 0.49-0.75) in univariate analysis. After adjusting for traditional risk factors, it was found that coronary atherosclerosis (OR 0.73, 95% CI 0.56-0.94 in the 4th quartile vs. 1st quartile) and calcified plaque (OR 0.66, 95% CI 0.53-0.84) were inversely associated with the bilirubin grade in a dose-dependent manner. Conclusions: The serum bilirubin level was inversely associated with coronary atherosclerosis and calcified plaques in a dose-dependent manner. These results suggested that serum bilirubin could be used as a protective biomarker of coronary artery disease.

Original languageEnglish
Pages (from-to)242-248
Number of pages7
JournalAtherosclerosis
Volume230
Issue number2
DOIs
StatePublished - 1 Oct 2013

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Bilirubin
Coronary Artery Disease
Coronary Vessels
Serum
Odds Ratio
Confidence Intervals
Pathologic Constriction
Cardiovascular Diseases
Tomography
Coronary Stenosis
Metabolic Diseases
Cross-Sectional Studies
Biomarkers
Incidence

Keywords

  • Atherosclerosis
  • Atherosclerotic
  • Bilirubin
  • Coronary stenosis
  • Plaque

Cite this

@article{b0806cad12004f418df370356953dcbe,
title = "Elevated serum bilirubin levels are inversely associated with coronary artery atherosclerosis",
abstract = "Background: Inverse correlations of high serum bilirubin with metabolic and cardiovascular disease have been suggested. However, anti-atherogenic effects of bilirubin have not been well-established in terms of the presence of plaques and stenosis identified in coronary computed tomography (CT). Methods: A cross-sectional study was conducted on 2862 men who were free of cardiovascular disease and underwent coronary CT as part of a routine medical screening examination. Coronary stenotic lesions were considered to be incidences of coronary atherosclerosis, and stenosis was classified as stenosis <50{\%} or ≥50{\%}, according to degree of stenosis. Results: The prevalences of coronary atherosclerosis and stenosis ≥50{\%} in subjects with elevated bilirubin levels (>1.2mg/dL) were lower than those in subjects with normal bilirubin levels (≤1.2mg/dL) (19.9{\%} vs. 27.9{\%}, p<0.001, 8.5{\%} vs. 10.3{\%}, p=0.044). Bilirubin was inversely associated with total plaques (odds ratio [OR] 0.59, 95{\%} confidence interval [CI] 0.48-0.73 in the 4th quartile vs. 1st quartile) and calcified plaques (OR 0.60, 95{\%} CI 0.49-0.75) in univariate analysis. After adjusting for traditional risk factors, it was found that coronary atherosclerosis (OR 0.73, 95{\%} CI 0.56-0.94 in the 4th quartile vs. 1st quartile) and calcified plaque (OR 0.66, 95{\%} CI 0.53-0.84) were inversely associated with the bilirubin grade in a dose-dependent manner. Conclusions: The serum bilirubin level was inversely associated with coronary atherosclerosis and calcified plaques in a dose-dependent manner. These results suggested that serum bilirubin could be used as a protective biomarker of coronary artery disease.",
keywords = "Atherosclerosis, Atherosclerotic, Bilirubin, Coronary stenosis, Plaque",
author = "Kang, {Seung Joo} and Donghee Kim and Park, {Hyo Eun} and Chung, {Goh Eun} and Choi, {Seung Ho} and Choi, {Su Yeon} and Whal Lee and Kim, {Joo Sung} and Cho, {Sang Heon}",
year = "2013",
month = "10",
day = "1",
doi = "10.1016/j.atherosclerosis.2013.06.021",
language = "English",
volume = "230",
pages = "242--248",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

TY - JOUR

T1 - Elevated serum bilirubin levels are inversely associated with coronary artery atherosclerosis

AU - Kang, Seung Joo

AU - Kim, Donghee

AU - Park, Hyo Eun

AU - Chung, Goh Eun

AU - Choi, Seung Ho

AU - Choi, Su Yeon

AU - Lee, Whal

AU - Kim, Joo Sung

AU - Cho, Sang Heon

PY - 2013/10/1

Y1 - 2013/10/1

N2 - Background: Inverse correlations of high serum bilirubin with metabolic and cardiovascular disease have been suggested. However, anti-atherogenic effects of bilirubin have not been well-established in terms of the presence of plaques and stenosis identified in coronary computed tomography (CT). Methods: A cross-sectional study was conducted on 2862 men who were free of cardiovascular disease and underwent coronary CT as part of a routine medical screening examination. Coronary stenotic lesions were considered to be incidences of coronary atherosclerosis, and stenosis was classified as stenosis <50% or ≥50%, according to degree of stenosis. Results: The prevalences of coronary atherosclerosis and stenosis ≥50% in subjects with elevated bilirubin levels (>1.2mg/dL) were lower than those in subjects with normal bilirubin levels (≤1.2mg/dL) (19.9% vs. 27.9%, p<0.001, 8.5% vs. 10.3%, p=0.044). Bilirubin was inversely associated with total plaques (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.48-0.73 in the 4th quartile vs. 1st quartile) and calcified plaques (OR 0.60, 95% CI 0.49-0.75) in univariate analysis. After adjusting for traditional risk factors, it was found that coronary atherosclerosis (OR 0.73, 95% CI 0.56-0.94 in the 4th quartile vs. 1st quartile) and calcified plaque (OR 0.66, 95% CI 0.53-0.84) were inversely associated with the bilirubin grade in a dose-dependent manner. Conclusions: The serum bilirubin level was inversely associated with coronary atherosclerosis and calcified plaques in a dose-dependent manner. These results suggested that serum bilirubin could be used as a protective biomarker of coronary artery disease.

AB - Background: Inverse correlations of high serum bilirubin with metabolic and cardiovascular disease have been suggested. However, anti-atherogenic effects of bilirubin have not been well-established in terms of the presence of plaques and stenosis identified in coronary computed tomography (CT). Methods: A cross-sectional study was conducted on 2862 men who were free of cardiovascular disease and underwent coronary CT as part of a routine medical screening examination. Coronary stenotic lesions were considered to be incidences of coronary atherosclerosis, and stenosis was classified as stenosis <50% or ≥50%, according to degree of stenosis. Results: The prevalences of coronary atherosclerosis and stenosis ≥50% in subjects with elevated bilirubin levels (>1.2mg/dL) were lower than those in subjects with normal bilirubin levels (≤1.2mg/dL) (19.9% vs. 27.9%, p<0.001, 8.5% vs. 10.3%, p=0.044). Bilirubin was inversely associated with total plaques (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.48-0.73 in the 4th quartile vs. 1st quartile) and calcified plaques (OR 0.60, 95% CI 0.49-0.75) in univariate analysis. After adjusting for traditional risk factors, it was found that coronary atherosclerosis (OR 0.73, 95% CI 0.56-0.94 in the 4th quartile vs. 1st quartile) and calcified plaque (OR 0.66, 95% CI 0.53-0.84) were inversely associated with the bilirubin grade in a dose-dependent manner. Conclusions: The serum bilirubin level was inversely associated with coronary atherosclerosis and calcified plaques in a dose-dependent manner. These results suggested that serum bilirubin could be used as a protective biomarker of coronary artery disease.

KW - Atherosclerosis

KW - Atherosclerotic

KW - Bilirubin

KW - Coronary stenosis

KW - Plaque

UR - http://www.scopus.com/inward/record.url?scp=84884584831&partnerID=8YFLogxK

U2 - 10.1016/j.atherosclerosis.2013.06.021

DO - 10.1016/j.atherosclerosis.2013.06.021

M3 - Article

C2 - 24075751

AN - SCOPUS:84884584831

VL - 230

SP - 242

EP - 248

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

IS - 2

ER -