Behavioral and clinical correlates of serum bilirubin concentrations in Japanese men and women

Abstract

BackgroundA considerable interest has been drawn to potential protective effects of bilirubin against oxidative stress-related diseases. Smoking is known to be associated with lower concentrations of serum bilirubin, but other behavioral correlates of serum bilirubin have not been well studied. In this cross-sectional study, we examined the associations of behavioral and clinical factors with serum total bilirubin in Japanese men and women.MethodThe study subjects comprised of 4802 men and 6414 women aged 49–76 years who participated in the baseline survey of an ongoing cohort study on lifestyle-related diseases in Fukuoka, Japan. With consideration to time of the day of blood sampling and fasting hours, the associations with smoking, alcohol intake, body mass index, physical activity, coffee, tea, blood pressure, glycated hemoglobin (HbA1c), HDL cholesterol and non-HDL cholesterol with serum bilirubin were evaluated by analysis of covariance and multiple linear regression analysis.ResultsWhile smoking was negatively associated with serum bilirubin, alcohol consumption was positively associated with serum bilirubin in both men and women. Coffee consumption was associated with lower bilirubin concentrations in both sexes. In the multiple linear regression analysis, HDL cholesterol was positively and HbA1c was negatively associated with bilirubin in both men and women, and the associations were more evident in women.ConclusionSmoking, alcohol use and coffee consumption were important behavioral correlates of serum bilirubin in Japanese men and women. Serum HDL cholesterol was a measurable clinical correlate of bilirubin in women.

Acute alcohol consumption elevates serum bilirubin: An endogenous antioxidant

“…This is not all together surprising in that epidemiological studies have shown that smokers have lower bilirubin levels than nonsmokers and former smokers (Hopkins et al, 1996; Madhavan et al, 1997; Tanaka et al, 2013; Van Hoydonck et al, 2001; Zucker et al, 2004), possibly through induction of UGT 1A1 by nicotine and/or other constituents of tobacco smoke (van der Bol et al, 2007) which may compensate for alcohol’s effects. However, the differential effects of alcohol on bilirubin concentrations for smokers and nonsmokers in our study must be considered very preliminary given the small sample size and differences in baseline characteristics between smokers and nonsmokers.…”

“…The positive association of bilirubin concentrations with various favorable health outcomes has been attributed to, but not proven to, be a consequence of it antioxidant properties.Determining whether multiple days of light drinking alcohol would show a cumulative or persistent effect on bilirubin levels is a critical next step. A recent epidemiological study has documented increased bilirubin levels in association with any level of alcohol consumption (Tanaka et al, 2013). …”

“…In contrast to the hypothesized effects of alcohol, tobacco smoking has been associated with lower concentrations of serum bilirubin in numerous epidemiological studies (Hopkins et al, 1996; Madhavan et al, 1997; Tanaka et al, 2013; Van Hoydonck et al, 2001; Zucker et al, 2004) and a recent study suggests that concentrations rise following smoking cessation (O’Malley et al, 2014). Induction of UGT 1A1, the primary pathway for disposition of bilirubin (Bosma et al, 1995), by nicotine and/or other constituents of tobacco smoke has been suggested as a mechanism for the reduction in bilirubin among smokers (van der Bol et al, 2007).…”

“…At the same time, another line of research has indicated that higher concentrations (but still well within accepted reference ranges) of serum bilirubin, a powerful antioxidant (Rizzo et al, 2010; Stocker et al, 1987), correlate with better health outcomes or conversely lower bilirubin concentrations with higher morbidities (Cheriyath et al, 2010; Curtin and Fairchild, 2003; Fischman et al, 2010; Horsfall et al, 2011; Novotny and Vitek, 2003; Perlstein et al, 2008; Rigato et al, 2005; Vitek and Schwertner, 2008; Wu et al, 2011). Of note, any drinking has been reported to be associated with higher, but still within the reference range, concentrations of serum bilirubin as compared to abstainers (Tanaka et al, 2013). Experimental research systematically linking these two observations, however, is lacking.…”

Investigation of gender and prandial state as factors affecting skin bilirubin level

“…This observation is agreeable in the work reported by Zucker et al [4], who observed a mean difference of 0.2 mg/dL in the value measured using in-vitro laboratories technique. This discrepancy may be contributed by factors such as differences in physical activities, body mass index and diet between females and the males as discussed in the work of Tanaka et al [11]. The relatively low standard deviation in the values predicted for males and females given by 0.007 µmol/L and 0.0086 µmol/L, respectively, may indicate the robustness of the proposed quantification approach towards differences in skin pigmentation.…”