Direct bilirubin is associated with low-density lipoprotein subfractions and particle size in overweight and centrally obese women

Kwon, Yu‐Jin; Lee, H.-S.; Lee, J.-W.

doi:10.1016/j.numecd.2018.05.013

Cited by 13 publications

(7 citation statements)

References 36 publications

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“… 26 One more recent study suggested that DBIL is more negatively correlated with levels of small, dense LDL compared with IBIL and TBIL. 27 Specifically, these authors all suggested that lower DBIL level was more strongly associated with a high prevalence of the disease than were TBIL and IBIL levels. However, no studies have reported the effects of individual bilirubin subtypes on diabetic microvascular complications.…”

Section: Discussionmentioning

confidence: 98%

“…In fact, the association between TBIL and ACR has been reported in several studies, but the results are inconsistent. 25 – 28 In a cross-sectional study with 93,909 subjects (aged 18–96 years, 53.0% male), the association between high serum bilirubin and decreased prevalence of diabetic kidney disease was not found in men. 28 Another cohort study with normal serum bilirubin subjects showed no significant association between serum bilirubin levels and the progression from normoalbuminuria to microalbuminuria.…”

Section: Discussionmentioning

confidence: 98%

“…DBIL, which binds weakly to albumin, plays an important role in preventing lipid peroxidation as a chain-breaking antioxidant. 38 An epidemiological study found that, compared with IBIL and TBIL, DBIL was more strongly correlated with a level of small, dense LDL 27 and metabolic syndrome, 24 which are risk factors for diabetic microvascular complications. DBIL-mediated inhibition of immune reactions and inflammatory processes, and as a marker reflecting heme oxygenase-1 activity, may be the other reason.…”

Section: Discussionmentioning

confidence: 99%

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Associations between different bilirubin subtypes and diabetic microvascular complications in middle-aged and elderly individuals

Wan

Zhu

Wang

et al. 2020

Therapeutic Advances in Endocrinology

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Aims: Some studies have reported associations between bilirubin and diabetic microvascular complications. However, these studies focused only on total bilirubin (TBIL) without distinguishing different bilirubin subtypes. In this study, we aimed to investigate the associations of TBIL, direct bilirubin (DBIL) and indirect bilirubin (IBIL) levels with albuminuria/creatinine ratio (ACR) and the prevalence of diabetic retinopathy (DR) among diabetic adults. Methods: We analyzed 4368 individuals out of 4813 diabetic participants enrolled from seven communities in 2018 in a cross-sectional study. Participants underwent several checkups, including the measurement of anthropometric parameters, blood pressure, glucose, lipid profile, TBIL, DBIL, IBIL and ACR. DR was detected by high-quality fundus photographs and was remotely read by ophthalmologists. Results: Compared with the first quartile of DBIL, participants in the fourth quartile had a lower prevalence of high ACR (odds ratio (OR) 0.76; 95% confidence interval (CI) 0.59, 0.99) ( p for trend < 0.05). Neither TBIL nor IBIL was associated with the prevalence of high ACR. In DR, higher DBIL and TBIL by one standard deviation was associated with a 19% (OR 0.81; 95% CI 0.69, 0.94) and a 12% (OR 0.88; 95% CI 0.78, 0.99) lower frequency of DR, respectively (both p for trend < 0.05). However, IBIL was not associated with the prevalence of DR. These associations were adjusted for potential confounding factors. Conclusion: DBIL had a stronger association with high ACR and DR than TBIL or IBIL did in diabetic adults. The effect of DBIL on diabetic complications should be noted and investigated in further studies.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Associations between different bilirubin subtypes and diabetic microvascular complications in middle-aged and elderly individuals

Wan

Zhu

Wang

et al. 2020

Therapeutic Advances in Endocrinology

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“…Reactive oxygen species promote bone resorption by directly stimulating osteoclast differentiation or indirectly increasing the expression of NF-κB ligand receptor activator in osteoblasts [ 23 , 24 ], and reactive oxygen species inhibit osteogenesis by regulating redox-sensitive signal pathways [ 25 ]. Total bilirubin is an effective antioxidant and can eliminate various forms of free radical oxygen species and inhibit the oxidation of lipids and lipoproteins [ 15 , 26 ]. Furthermore, osteoporosis caused by oxidative stress may be related to endothelial dysfunction and decreased blood flow in bone tissue [ 27 ]; bilirubin can inhibit the activation and dysfunction of vascular endothelium in response to proinflammatory stress [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Association between total bilirubin and bone mineral density level in adolescents

Wang

et al. 2022

BMC Musculoskelet Disord

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Background Increasing bone mass accumulation in adolescence and obtaining greater peak bone mass is one of the effective methods to prevent osteoporosis in the future. We aimed to examine the association between total bilirubin and bone mineral density (BMD) level in adolescents. Methods We used the data from 2005–2010 and 2013–2014 cycles of National Health and Nutrition Examination Survey (NHANES). The BMD levels in the region of lumbar spine and femoral regions, including total femur, femoral neck, trochanter, and intertrochanter were measured. Univariable and multivariable linear regression model were used to assess the relationship between total bilirubin concentration and BMD. Results A total of 3741 participants aged 12–19 years were ultimately included in the study. There were 1997 (53.38%) males and 1744 (46.62%) females. Univariate analysis results showed that age, sex, race, education, income, body mass index, dietary calcium intake, and diabetes were correlated with BMD levels. Compared with the lowest quartile of total bilirubin concentration, the highest quartile of total bilirubin concentration was positively associated with BMD levels in the regions of total femur (β = 0.036, 95% CI = 0.021 to 0.050, P < 0.001), femur neck (β = 0.030, 95% CI = 0.016 to 0.044, P < 0.001), trochanter (β = 0.033, 95% CI = 0.019 to 0.046, P < 0.001), intertrochanter (β = 0.040, 95% CI = 0.023 to 0.056, P < 0.001), and lumbar spine (β = 0.032, 95% CI = 0.018 to 0.045, P < 0.001). We also observe the same trend in sensitivity analysis (P for trend < 0.001). Conclusion Our study demonstrated that total bilirubin concentration was positively associated with BMD levels in adolescents in United States. Total bilirubin concentration might be a protective marker against bone loss in adolescents.

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“…Total bilirubin has a detrimental effect on cell viability, cell differentiation and mineralization of primary human osteoblasts in a dose-dependent manner (11). In addition, total bilirubin is an end metabolic product of heme degradation and servers as a potent antioxidant to inhibit the oxidization of lipids and lipoprotein (especially low density lipoprotein) and eliminate radical oxygen species in the various forms including free, albumin-bound, unconjugated and conjugated forms (16,35). Osteoporosis caused by oxidative stress may be also associated with endothelial dysfunction and decreased blood flow for bone tissue (36,37).…”

Section: Discussionmentioning

confidence: 99%

Systematic Influence of Circulating Bilirubin Levels on Osteoporosis

et al. 2021

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Observational studies report some association between circulating bilirubin levels and osteoporosis, but it is unknown if this association is causal or confounded. In this two-sample Mendelian randomization (MR) study, we included a large genome-wide association study (GWAS) associated with total bilirubin levels among 317,639 people, a large meta-analysis to identify genetic variants associated with bone mineral density (BMD) estimated by heel quantitative ultrasound (eBMD) among 426,824 individuals and fracture among 1.2 million individuals. The results revealed that circulating bilirubin levels had no causal influence on eBMD (beta-estimate: 0.004, 95% confidence interval [CI]: -0.019 to 0.028, SE:0.012, P-value=0.705) or the risk of fracture (beta-estimate: -0.009, 95% CI: -0.035 to 0.017, SE:0.013, P-value=0.488), which were both confirmed by multiple sensitivity analyses. Our results confirm that circulating bilirubin levels have no causal role in eBMD or the incidence of fracture, indicating that circulating bilirubin levels is unlikely to be a causal risk factor for osteoporosis or fracture.

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Direct bilirubin is associated with low-density lipoprotein subfractions and particle size in overweight and centrally obese women

Cited by 13 publications

References 36 publications

Associations between different bilirubin subtypes and diabetic microvascular complications in middle-aged and elderly individuals

Associations between different bilirubin subtypes and diabetic microvascular complications in middle-aged and elderly individuals

Association between total bilirubin and bone mineral density level in adolescents

Systematic Influence of Circulating Bilirubin Levels on Osteoporosis

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