Inverse relationship between serum total bilirubin levels and severity of disease in patients with stable coronary artery disease

Turfan, Murat; Duran, Mustafa; Poyraz, Fatih; Yayla, Çağrı; Akboğa, Mehmet Kadri; Şahinarslan, Asife; Tavıl, Yusuf; Paşaoğlu, Hatîce; Boyacı, Bülent

doi:10.1097/mca.0b013e32835b0c13

Cited by 31 publications

(27 citation statements)

References 1 publication

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“…These myriad clinical actions of bilirubin suggest that there is teleological benefit to the seemingly counterproductive conversion of water-soluble, readily excretable biliverdin to highly water-insoluble UB that must be conjugated with glucuronides to become water soluble and hence excretable by the liver and kidney. Support for a beneficial effect of UB is provided by multiple studies showing a negative association between serum bilirubin concentration and various diseases such as coronary artery disease in subjects with normal liver function,22–24 as well as in subjects with Gilbert’s syndrome 25…”

Section: Ub: Production Solubility Albumin Binding and Pharmacokinmentioning

confidence: 99%

Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease

Levitt¹,

Levitt²

2014

CEG

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Serum bilirubin measurements are commonly obtained for the evaluation of ill patients and to screen for liver disease in routine physical exams. An enormous research effort has identified the multiple mechanisms involved in the production and metabolism of conjugated (CB) and unconjugated bilirubin (UB). While the qualitative effects of these mechanisms are well understood, their expected quantitative influence on serum bilirubin homeostasis has received less attention. In this review, each of the steps involved in bilirubin production, metabolism, hepatic cell uptake, and excretion is quantitatively examined. We then attempt to predict the expected effect of normal and defective function on serum UB and CB levels in health and disease states including hemolysis, extra- and intrahepatic cholestasis, hepatocellular diseases (eg, cirrhosis, hepatitis), and various congenital defects in bilirubin conjugation and secretion (eg, Gilbert’s, Dubin–Johnson, Crigler–Najjar, Rotor syndromes). Novel aspects of this review include: 1) quantitative estimates of the free and total UB and CB in the plasma, hepatocyte, and bile; 2) detailed discussion of the important implications of the recently recognized role of the hepatic OATP transporters in the maintenance of CB homeostasis; 3) discussion of the differences between the standard diazo assay versus chromatographic measurement of CB and UB; 4) pharmacokinetic implications of the extremely high-affinity albumin binding of UB; 5) role of the enterohepatic circulation in physiologic jaundice of newborn and fasting hyperbilirubinemia; and 6) insights concerning the clinical interpretation of bilirubin measurements.

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Section: Ub: Production Solubility Albumin Binding and Pharmacokinmentioning

confidence: 99%

Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease

Levitt¹,

Levitt²

2014

CEG

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“…According to many studies [4,5] it is known that free bilirubin has marked antioxidant properties due to its ability to prevent lipid peroxidation of cell membranes and membrane protein oxidation, showing particular tropism for nerve tissue and heart muscle. Thus, according to the findings of M. K. Akboga, U. Canpolat, A. Sahinarslan et al in 2015, serum bilirubin has significant inverse correlation with specific and non-specific markers of systemic inflammation such as C-reactive protein, a neutrophil and lymphocyte ratio (NLR) etc.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic value of blood urea and bilirubin levels determination in patients with gastroduodenal zone diseases

Zhakun

Sorokopud

Strilchuk

et al. 2017

ZMJ

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The study of relationships of urea and bilirubin blood levels in patients with Helicobacter pylori associated gastroduodenal pathology (HP-aGDP) has the considerable relevance for clinicians, since these indicators represent the status and function of the gastroduodenal zone.The aim of this study was to estimate changes of bilirubin and urea blood levels in patients with HP-aGDP before and after treatment.Materials and methods. Our study has included 59 patients of the main group with different HP-aGDP and 44 patients of the control group with community-acquired pneumonia (CAP). Results.In patients with HP-aGDP the doubly severe reduction of urea concentration was observed in significantly greater number of patients, while half of the patients in the controls had an increase of its level by 10.4 %. The bilirubin concentration decrease was more pronounced (37.1 % vs. 3.5 %) and significant (P < 0.05) in patients with HP-aGDP. Its rate depended on the dynamics of urea exactly in patients with HP-aGDP and it was more pronounced in case of urea reduction (P < 0.05). Thus, the revealed association of bilirubin and urea levels changes, namely their decrease owing to the treatment, was inherent only to patients with HP-aGDP unlike to the patients with CAD. We also determined the involvement of lipid, carbohydrate and protein metabolism, electrolytes, composition of blood in the processes of local and systemic inflammation caused by HP and its relationship with adaptive reactions, which generally depended on other individual characteristics of patients in the study group (age, duration of disease, ulcer size, etc.). Conclusions.The monitoring of urea and bilirubin blood levels in patients especially with HP-aGDP during the eradication has a specific diagnostic and prognostic value. The bilirubin level in such cases reflects the severity of cholestasis, inflammatory lesions of the duodenal mucosa, comorbid hepatobiliary disease, while the urea level reduction may be an additional criterion of efficacy of HP eradication.Діагностичне значення визначення вмісту сечовини та білірубіну крові в пацієнтів із хворобами гастродуоденальної зониВивчення взаємозв'язків умісту сечовини та білірубіну крові в пацієнтів із HP-aGDP має істотне значення для клініцистів, оскільки ці показники відбивають стан і функцію органів гастродуоденальної зони, їхні зміни можуть мати вагоме значення в оцінюванні стану подібних пацієнтів.Мета роботи -оцінювання змін вмісту білірубіну й сечовини крові, інших параметрів метаболізму, показників крові до та після лікування пацієнтів із HP-aGDP.Матеріали та методи. Дослідження включало 59 пацієнтів основної групи з різними HP-aGDP і 44 особи контрольної групи з CAP.Результати. Динаміка змін рівня сечовини крові в пацієнтів із НР-aGDP і пацієнтів із CAP значно відрізнялась: удвічі більш виражене зниження концентрації сечовини спостерігалось у більшої кількості пацієнтів основної групи, в той час як у половини пацієнтів контрольної групи визначалось збільшення її рівня на 10,4 %. Зниження концентрації біліруб...

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“…Low or medium level of serum bilirubin has been proved to acts as protective effect for cardiovascular system through antioxygen free radical activity in non-jaundice people 19-21. Based on these facts, some researchers even add small dose of bilirubin to alleviate the risks of cardiovascular and other systems 22.…”

Section: Discussionmentioning

confidence: 99%

Plasma BNP level combined with surgical Apgar score to predict operative major cardiac adverse events in malignant obstructive jaundice patients

Huang

Wang

et al. 2016

Pak J Med Sci

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Objective:To investigate the predictive effect of major adverse cardiac events (MACE) in malignant obstructive jaundice (OJ) patients using plasma brain natriuretic peptide (BNP) level and surgical Apgar scoring (SAS) system.Methods:Forty one malignant OJ patients undergoing surgical treatments were studied at a single center. Pre-and postoperative plasma BNP level, total bilirubin (TBil) and data of cardiac function (HR, CVP, CI, LVEF%) were detected, the SAS was calculated during the surgery, the relationship of both plasma BNP level and SAS with MACE after surgery was analyzed.Results:Thirteen patients out of 41 (31.71%) experienced MACE without cardiac death. OJ patients had a higher plasma BNP level than baseline before operation (191.61±105.76 pg/ml VS 175 pg/ml, P<0.05), the cardiac function data was improved (CVP: t=4.761, p=0.000; CI: t=3.539, p=0.001; LVEF%: t=3.632, p=0.001) after the operation. Patients with lower SAS had increasing incidence of MACE after surgery.Conclusion:Malignant OJ patients with higher preoperative BNP level and lower surgical Apgar score were identified at high risk of MACE after surgery.

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Inverse relationship between serum total bilirubin levels and severity of disease in patients with stable coronary artery disease

Abstract: Serum bilirubin levels were independently and inversely associated with the severity of disease in patients with stable CAD. Serum total bilirubin level may be useful as a marker of the severity of CAD.

Cited by 31 publications

References 1 publication

Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease

Quantitative assessment of the multiple processes responsible for bilirubin homeostasis in health and disease

Diagnostic value of blood urea and bilirubin levels determination in patients with gastroduodenal zone diseases

Plasma BNP level combined with surgical Apgar score to predict operative major cardiac adverse events in malignant obstructive jaundice patients

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