Serum bilirubin is associated with lung function in a Swiss general population sample

Ivan, Cristina; Imboden, Medea; Adam, Martin; Bettschart, Robert; Gerbase, Margaret W.; Künzli, Nino; Rochat, Thierry; Rohrer, Lucia; Rothe, Thomás; Schwartz, Joel; Stolz, Daiana; Tschopp, Jean‐Marie; Eckardstein, Arnold von; Kronenberg, Florian; Probst‐Hensch, Nicole

doi:10.1183/09031936.00055813

Cited by 30 publications

(45 citation statements)

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“…Another group recently reported associations between a SNP, linked to bilirubin levels from genome wide association studies and respiratory function in a Swiss cohort [9]. This study reported interactions with serum bilirubin and smoking status for the full cohort (n = 4195) but lacked power to examine genetic interactions with smoking for the subset with DNA (n = 982).…”

Section: Discussionmentioning

confidence: 94%

“…For example, bilirubin infusions can protect against bleomycin-induced pulmonary fibrosis in rats [6]. Cohort studies have reported lower rates of respiratory diseases and increased respiratory function in people with comparatively higher serum bilirubin levels after accounting for important confounders including smoking status [7][8][9]. However reverse causation where the disease process alters bilirubin levels or residual confounding by unmeasured confounders could potentially explain these relationships.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Genetic variation underlying common hereditary hyperbilirubinaemia (Gilbert’s syndrome) and respiratory health in the 1946 British birth cohort

Horsfall¹,

Hardy²,

Wong³

et al. 2014

Journal of Hepatology

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Genetic variation underlying common hereditary hyperbilirubinaemia (Gilbert’s syndrome) and respiratory health in the 1946 British birth cohort

Horsfall¹,

Hardy²,

Wong³

et al. 2014

Journal of Hepatology

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show abstract

“…Patients who had a higher level of bilirubin may had a lower response of oxidative stress in their body. Several studies have found that high bilirubin level is signi cantly associated with higher forced expiratory volume in 1 s to forced vital capacity(FEV1/FVC) and mean forced expiratory ow between 25 and 75% of FVC (FEF25-75%) [29][30]. It suggests that bilirubin may has a protective effect on lung tissue by impressing the in ammation and oxidative stress response in lungs [31], and was associated with a lower risk of respiratory disease and all-cause mortality [32].…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of NLR and Bilirubin Levels in the Readmission of AECOPD

Dai

Liang²,

2020

Preprint

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Objective To analyze acute exacerbation of chronic obstructive pulmonary disease(AECOPD) readmission events and to determine whether neutrophil-to-lymphocyte ratio(NLR) and bilirubin level are associated with readmission after discharge due to AECOPD .Methods A total of 170 patients with AECOPD were included. Patients were stratified into the readmission group if patients have two or more readmission within 2 years of the previous discharge and non-readmission group with one readmission or none within 2 years of the last discharge. Basic characteristics, laboratory examinations and clinical data of them were collected retrospectively and compared between these two groups. Then the patients were separated by the cutoffs of NLR and bilirubin level. The number of all-cause readmission within 2 years, time to first COPD-related readmission, 1-year and 2-year COPD-related readmission, 1-year and 2-year all-cause mortality were compared between groups respectively .Results Compared with readmission group, patients of non-readmission group had shorter length of hospital stay(P=0.034), more systemic corticosteroids use(P=0.007), higher NLR(P=0.001), higher bilirubin levels(P=0.010) and lower eosinophils counts(P=0.001). NLR and bilirubin level at admission can significantly influence the number of all-cause readmission(p=0.002, P<0.001, respectively). Lower bilirubin was associated with an increased risk of 1-year COPD-related readmission(OR 5.063, 95%CI 1.091-23.498) and 2-year COPD-related readmission(OR 4.699, 95% CI 1.269-17.396) .Conclusion For patients with AECOPD, longer hospital stay and less use of systemic corticosteroids may be associated with higher risk of readmission. NLR and bilirubin level at admission may be related to the number of all-cause readmission. Bilirubin can be regarded as a biomarker to predict readmission rates within 2 years after discharged throughout the course of disease.

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“…Another recent prospective study found that, in current smokers, lower bilirubin levels predicted a higher risk of developing and dying from lung cancer [50]. In a large Swiss cohort, serum bilirubin correlated positively with parameters of effective lung function [51]. And, in a rat model of smoking-induced emphysema, intraperitoneal administration of bilirubin suppressed pulmonary injury, decreasing influx of inflammatory cells and lessening proinflammatory cytokines in bronchoalveolar lavage fluid [48].…”

Section: Complementary Protection From Spirulina?mentioning

confidence: 99%

DHA May Have a Profoundly Protective Impact on the Lungs of Smokers

Mf¹

2016

J Nutr Food Sci

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Evidence has accumulated over the last twenty years that smokers who frequently ingest fish are at lower risk for both chronic obstructive pulmonary disease (COPD) and lung cancer. Plasma phospholipid levels of DHA, but not EPA, have been reported to correlate inversely with risk for COPD in smokers, suggesting that DHA may be primarily responsible for the apparent protection afforded to lungs of smokers by fish consumption. Meanwhile, evidence is emerging that certain metabolites of DHA -including 4 -hydroxy hexenal (4-HHE), 17 -oxo -DHA, and resolvin D1 -can activate Nrf2 -mediated transcription of heme oxygenase -1 and other antioxidant / cytoprotective enzymes. Since the oxidant stress imposed by cigarette smoke exposure could be expected to promote peroxidation of membrane DHA and hence boost production of 4 -HHE, DHA in lung membranes may in effect up-regulate the protective feedback mechanism whereby oxidative stress provokes Nrf2 -mediated induction of cytoprotective enzymes. DHA can also give rise to the autacoid resolvin D1, which, via activation of a receptor, suppresses NFkappaB activation and the consequent production of pro-inflammatory cytokines. Resolvin D1 can also inhibit macrophage NADPH oxidase and promote an anti-inflammatory M2 phenotype in lung macrophages. Not surprisingly, inhalation of resolvin D1 has a marked anti-inflammatory impact on the lungs of mice exposed to tobacco smoke. These considerations help to rationalize the epidemiology linking fish consumption to lung health, and suggest that smokers who can't or won't quit their habit would be well advised to consume fish or DHA supplements regularly. Higher intakes of fruits and vegetables -likely in part because many of these contain Nrf2 -activating phytochemicals -likewise are associated with lower risk for COPD, and can be recommended for smokers.Keywords: COPD; Lung cancer; Fish; Docosahexaenoic acid (DHA); 4 -hydroxy hexenal; Nrf2; Resolvin D1 Fish Consumption May Protect Smokers from COPDLimited but nonetheless compelling epidemiology has linked heavy dietary consumption of fresh fish to marked decreases in risk for lung cancer and chronic obstructive pulmonary disease (COPD) among smokers. The first key evidence in this regard emerged in 1994. Shahar et al.[1] studied subjects enrolled in the prospective Atherosclerosis Risk in Communities (ARIC) study, who had received a dietary assessment and a physical exam including lung spirometry, and had been questioned regarding lung symptoms [1]. COPD was defined by three separate criteria: self -reported symptoms of chronic bronchitis, physician diagnosis of emphysema, and via spirometry (FEV1 < 65% of predicted value). When risk for COPD was compared between the first and fourth quartiles of estimated daily intake of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA), relative risk for COPD in the fourth quartile (mean omega-3 intake 480 mg) after appropriate multivariate adjustments was found to be 0.66 (95% CI 0.52 -0.85), 0.31 (CI 0.18 -0.52), and 0.50 (CI 0.32...

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Serum bilirubin is associated with lung function in a Swiss general population sample

Cited by 30 publications

References 30 publications

Genetic variation underlying common hereditary hyperbilirubinaemia (Gilbert’s syndrome) and respiratory health in the 1946 British birth cohort

Genetic variation underlying common hereditary hyperbilirubinaemia (Gilbert’s syndrome) and respiratory health in the 1946 British birth cohort

Predictive Value of NLR and Bilirubin Levels in the Readmission of AECOPD

DHA May Have a Profoundly Protective Impact on the Lungs of Smokers

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