title: Gilbert's syndrome and the risk of death: a population-based cohort study.
abstract: OBJECTIVE
  Gilbert's syndrome is a common familial hyperbilirubinemia that may reduce the risk of various age-related diseases because of the antioxidant properties of bilirubin. We conducted a large cohort study using The Health Improvement Network primary care database and compared all-cause mortality rates in those with and without Gilbert's syndrome.
  
  
  METHODS
  Mortality rates in patients with a diagnosis of Gilbert's syndrome and raised bilirubin level (n = 4266) were compared with those of patients with similar characteristics but with normal bilirubin levels (n = 21 968). Multivariate Poisson regression was also used to estimate adjusted mortality rate ratios.
  
  
  RESULTS
  During the 350 000 PYs of follow up across the Gilbert's and comparison cohorts, there were 1174 deaths. Mortality rates were 24/10 000 PYs in the Gilbert's cohort versus 50/10 000 PYs in the comparison cohort. Mortality rates were around half in patients with Gilbert's syndrome after accounting for sociodemographics and general health indicators (adjusted mortality rate ratio: 0.5 [95% confidence interval; 0.4-0.7; P < 0.001]).
  
  
  CONCLUSIONS
  Mortality rates observed for people with Gilbert's syndrome in the general population are almost half those of people without evidence of Gilbert's syndrome.
authors.affiliation: Research Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, UK.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Horsfall
authors.forename: Irwin
authors.initials: I
authors.lastname: Nazareth
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Pereira
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
mesh_terms: D000328:Adult; D000975:Antioxidants; D001663:Bilirubin / Q000097:blood; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D005878:Gilbert Disease / Q000235:genetics / Q000401:mortality*; D014453:Glucuronosyltransferase / Q000172:deficiency; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012306:Risk; D006113:United Kingdom / Q000453:epidemiology; D000099148:UGT1A1 Enzyme
chemical_list: D000975:Antioxidants; D001663:Bilirubin; D014453:Glucuronosyltransferase; D000099148:UGT1A1 Enzyme
keywords: Gilbert disease; bilirubin; bilirubin uridine-diphosphoglucuronosyl transferase 1A1; cohort; database; mortality