Serum Bilirubin Associated with Stroke Severity and Prognosis: Preliminary Findings on Liver Function after Acute Ischemic Stroke

Duan, Honglian; Cheng, Zhe; Yun, Ho Jun; Cai, Lining; Tong, Yanna; Han, Zhenzhen; Xu, Geng; Ding, Yuchuan

doi:10.1080/01616412.2022.2119724

Cited by 10 publications

(7 citation statements)

References 48 publications

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“…Several studies have detected increased levels of serum bilirubin during the early phase of stroke [ 30 , 31 , 32 , 33 ]. Bilirubin was suggested to be a negative prognostic biomarker of ischemic stroke; a higher serum bilirubin level at clinical presentation is associated with greater stroke severity and a greater degree of disability at 3 months after AIS [ 31 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity

Chen

Lin

Long

et al. 2023

JCM

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Background: Hemorrhagic transformation (HT) is a severe complication in patients with acute ischemic stroke (AIS). This study was performed to explore and validate the relation between bilirubin levels and spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT). Methods: The study population consisted of 408 consecutive AIS patients with HT and age- and sex-matched patients without HT. All patients were divided into quartiles according to total bilirubin (TBIL) level. HT was classified as hemorrhagic infarction (HI) and parenchymal hematoma (PH) based on radiographic data. Results: In this study, the baseline TBIL levels were significantly higher in the HT than non-HT patients in both cohorts (p < 0.001). Furthermore, the severity of HT increased with increasing TBIL levels (p < 0.001) in sHT and tHT cohorts. The highest quartile of TBIL was associated with HT in sHT and tHT cohorts (sHT cohort: OR = 3.924 (2.051–7.505), p < 0.001; tHT cohort: OR = 3.557 (1.662–7.611), p = 0.006). Conclusions: Our results suggest that an increased TBIL is associated with a high risk of patients with sHT and tHT, and that TBIL is more suitable as a predictor for sHT than tHT. These findings may help to identify patients susceptible to different types and severity of HT.

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Section: Discussionmentioning

confidence: 99%

Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity

Chen

Lin

Long

et al. 2023

JCM

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“…Taking stroke severity (NIHSS score) into account, our study still showed that high serum bilirubin levels were associated with increased risk of HT. A few studies reported that patients with AIS with elevation of serum bilirubin levels had lower risk of early neurological deterioration ( Sheng et al, 2021 ) and increased odds of good functional outcomes ( Duan et al, 2022 ). However, more studies revealed that elevated serum bilirubin levels were independent predictors of poor functional outcome after AIS ( Wang et al, 2018 ; Ouyang et al, 2021 ; Peng et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…A cross-sectional study showed that patients with prior stroke with higher serum total bilirubin levels less tended to suffer an adverse stroke outcome ( Perlstein et al, 2008 ). The evidence from cohort study showed increased odds of favorable functional outcomes in patients with mild stroke with elevated levels of total bilirubin and direct bilirubin ( Duan et al, 2022 ). However, bilirubin also has neurotoxic effect and numerous studies find that higher serum bilirubin levels are associated with poor functional outcomes in patients with AIS ( Wang et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Higher serum bilirubin levels are associated with hemorrhagic transformation after intravenous thrombolysis in acute ischemic Stroke

Chen

Yang

et al. 2023

Front. Aging Neurosci.

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BackgroundBilirubin has both antioxidative and prooxidative properties. The study aimed to explore the relationship between serum bilirubin and hemorrhagic transformation (HT) after intravenous thrombolysis in patients with acute ischemic stroke.MethodsThe patients receiving intravenous thrombolysis with alteplase were retrospectively analyzed. HT was defined as new intracerebral hemorrhage in follow-up computed tomography images within 24–36 h after thrombolysis. Symptomatic intracranial hemorrhage (sICH) was defined as HT accompanied by worsening neurological function. Multivariate logistic regression and spline regression models were performed to investigate the relationship between serum bilirubin levels and the risk of HT and sICH.ResultsAmong 557 included patients, 71 (12.7%) were diagnosed with HT and 28 (5.0%) developed sICH. Patients with HT had significant higher baseline serum total bilirubin, direct bilirubin, and indirect bilirubin levels than those without HT. Multivariable logistic regression analysis indicated that patients with higher serum bilirubin levels, including total bilirubin (OR 1.05, 95% CI 1.01–1.08, p = 0.006), direct bilirubin (OR 1.18, 95% CI 1.05–1.31, p = 0.004), and indirect bilirubin (OR 1.06, 95% CI 1.02–1.10, p = 0.005) had increased risk of HT. Furthermore, multiple-adjusted spline regression models excluded nonlinear association between serum bilirubin levels and HT (p > 0.05 for nonlinearity). Similar results were present between serum bilirubin and sICH.ConclusionThe data showed the positively linearly relationship between serum bilirubin levels and the risk of HT and sICH in patients with acute ischemic stroke undergoing intravenous thrombolysis.

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“…The central nervous system has long been thought to be harmed by bilirubin, a hemoglobin breakdown product that includes direct and indirect bilirubin. 16 An defective liver function is indicated by elevated bilirubin. 17…”

Section: Discussionmentioning

confidence: 99%

Association of Triglyceride-Glucose Index and Liver Function Parameters Among Healthy Obese Civil Servants: A Center-Based Study

Pan¹,

Yue²,

Ren³

et al. 2022

DMSO

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To investigate the correlation between Triglyceride-glucose (TyG) index and liver function parameters in healthy obese civil servants in Shijiazhuang, China. Materials and Methods: This was an outpatient-based cross-sectional study in which 6452 participants were recruited. A total of 784 participants were analyzed according to inclusion and exclusion criteria. A TyG index was calculated based on fasting glucose and triglycerides. All patients were divided into a high TyG index group and a low TyG index group, using the median TyG index as a cutoff. Finally, patients were further divided into two subgroups: males and females. Results: While AST/ALT and direct bilirubin levels were lower in the high TyG index group compared to the low TyG index group, ALT, AST, total protein, and albumin levels were greater. Particularly in male participants, TyG index was inversely connected with AST/ALT and direct bilirubin levels and favorably correlated with ALT, AST, total protein, and albumin levels. These connections persisted in the multilinear regression study even after adjusting for confounding variables. Conclusion:This study describes the correlation between TyG index and liver function parameters in obese populations without comorbid diseases, providing a new idea for early interventional treatment in this group.

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Serum Bilirubin Associated with Stroke Severity and Prognosis: Preliminary Findings on Liver Function after Acute Ischemic Stroke

Cited by 10 publications

References 48 publications

Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity

Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity

Higher serum bilirubin levels are associated with hemorrhagic transformation after intravenous thrombolysis in acute ischemic Stroke

Association of Triglyceride-Glucose Index and Liver Function Parameters Among Healthy Obese Civil Servants: A Center-Based Study

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