title: Lower carotid intima media thickness is predicted by higher serum bilirubin in both non-diabetic and Type 2 diabetic subjects.
abstract: BACKGROUND
  Higher serum bilirubin levels may be implicated cardiovascular protection. It is unknown whether the impact of serum bilirubin on carotid artery intima media thickness (IMT), a marker of subclinical atherosclerosis, is different in diabetic subjects compared to non-diabetic subjects. We assessed relationships of IMT with serum total bilirubin in non-diabetic and Type 2 diabetic subjects without clinically manifest cardiovascular disease.
  
  
  METHODS
  IMT, total bilirubin, transaminases, C-reactive protein (CRP) and lipid levels were measured in 40 predominantly middle-aged non-diabetic and 80 diabetic subjects.
  
  
  RESULTS
  IMT was higher in diabetic subjects compared to non-diabetic subjects (unadjusted, p<0.001), whereas bilirubin was not different (p=0.82). In both non-diabetic and in diabetic subjects, IMT was negatively related to bilirubin (β=-0.316, p=0.045 and β=-0.247 p=0.014, respectively) taking account of age, sex and mean arterial pressure. In the combined subjects, IMT remained independently related to bilirubin (β=-0.183, p=0.028) after additional adjustment for diabetes status, alcohol intake, transaminases, CRP and lipid levels. There was no interaction of bilirubin with the presence of diabetes on IMT (p=0.98).
  
  
  CONCLUSIONS
  Carotid artery IMT relates negatively to bilirubin in non-diabetic and Type 2 diabetic subjects. The association of subclinical atherosclerosis with bilirubin appears to be unaltered in the diabetic state.
authors.affiliation: Department of Endocrinology, University Medical Center Groningen, Groningen, The Netherlands. r.p.f.dullaart@int.umcg.nl
authors.forename: Robin P F
authors.initials: RP
authors.lastname: Dullaart
authors.forename: Paul J W H
authors.initials: PJ
authors.lastname: Kappelle
authors.forename: Rindert
authors.initials: R
authors.lastname: de Vries
mesh_terms: D001663:Bilirubin / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D000637:Transaminases / Q000097:blood
chemical_list: D008055:Lipids; D002097:C-Reactive Protein; D000637:Transaminases; D001663:Bilirubin