title: Inverse relation of total serum bilirubin to coronary artery calcification score detected by multidetector computed tomography in males.
abstract: BACKGROUND
  Serum total bilirubin has been suggested to have potential anti-inflammatory and antioxidant effects on the vasculature, acting against plaque formation and subsequent atherosclerosis. This study was designed to assess the association of serum total bilirubin with coronary artery calcification (CAC).
  
  
  OBJECTIVE
  Individuals with higher bilirubin level would be less likely to develop CAC.
  
  
  METHODS
  Male subjects (N = 3408) underwent evaluation of CAC by cardiac computed tomography. Correlation and logistic regression analysis were performed to assess the relationships between CAC score and other variables.
  
  
  RESULTS
  Subjects with a higher CAC score had significantly lower total bilirubin level (P = 0.001). Total bilirubin level was negatively correlated with CAC score (r = -0.052, P = 0.002). A 0.1-mg/dL increase in bilirubin was associated with a reduced odds ratio (OR) of the risk by 29.2% for a CAC score above 100 (OR: 0.708, 95% confidence interval: 0.542-0.927, P = 0.012) after adjustment for several variables. Bilirubin was inversely correlated with high-sensitivity C-reactive protein (hsCRP) (r = -0.117, P < 0.001).
  
  
  CONCLUSIONS
  This study demonstrated an independent inverse association between serum total bilirubin and CAC score in males. Low serum bilirubin concentration would be useful as a potential risk factor for CAC in males. Additionally, reduced hsCRP may be 1 of the mechanisms for how bilirubin reduces CAC.
authors.affiliation: Department of Surgery, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Zheng-Yun
authors.initials: ZY
authors.lastname: Zhang
authors.forename: Lu-Qin
authors.initials: LQ
authors.lastname: Bian
authors.forename: Sung-Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Cai-Cun
authors.initials: CC
authors.lastname: Zhou
authors.forename: Yoon-Ho
authors.initials: YH
authors.lastname: Choi
mesh_terms: D001663:Bilirubin / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D003331:Coronary Vessels / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012307:Risk Factors; D012720:Severity of Illness Index; D061205:Vascular Calcification / Q000097:blood* / Q000473:pathology*
chemical_list: D002097:C-Reactive Protein; D001663:Bilirubin