title: Serum bilirubin is inversely associated with insulin resistance and metabolic syndrome among children and adolescents.
abstract: OBJECTIVE
  Bilirubin is a potent antioxidant and a cyroprotectant. Low serum bilirubin is associated with atherosclerosis. Little is known about its role in metabolic syndrome (MS) among children and adolescents.
  
  
  METHODS
  We examined 4723 children and adolescents aged 12-17 years with reliable measures of various serum hepatic profiles and metabolic risks from Health and Nutrition Examination Survey 1999-2004.
  
  
  RESULTS
  The results showed that the prevalence of the MS was from 6.6+/-1.2% in the lowest quartile to 2.1+/-1.9% in the highest quartile of the concentration of total bilirubin. The graded association remained significant after the adjustment of other co-variates. The odds ratios for the MS were around 0.29 (0.08-0.99) and 0.23 (0.08-0.65) for the upper two quartiles when using the lowest quartile as reference for the concentration of total bilirubin. The quartiles of the serum total bilirubin levels were inversely correlated with the homeostasis model assessment (HOMA-IR) and insulin while not associated with the serum C-reactive protein (CRP) levels.
  
  
  CONCLUSIONS
  The serum total bilirubin levels are inversely correlated with the prevalence of the MS. The mechanism of the association between MS and total bilirubin may be related to the insulin resistance status.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Lin
authors.forename: Hsu-Ko
authors.initials: HK
authors.lastname: Kuo
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.forename: Ling-Ping
authors.initials: LP
authors.lastname: Lai
authors.forename: Fu-Tien
authors.initials: FT
authors.lastname: Chiang
authors.forename: Chuen-Den
authors.initials: CD
authors.lastname: Tseng
authors.forename: Jiunn-Lee
authors.initials: JL
authors.lastname: Lin
mesh_terms: D000293:Adolescent; D000975:Antioxidants / Q000378:metabolism; D001663:Bilirubin / Q000097:blood* / Q000737:chemistry; D002097:C-Reactive Protein / Q000096:biosynthesis; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D016017:Odds Ratio; D015995:Prevalence
chemical_list: D000975:Antioxidants; D002097:C-Reactive Protein; D001663:Bilirubin