title: The evaluation of relationship between adiponectin levels and epicardial adipose tissue thickness with low cardiac risk in Gilbert`s syndrome: an observational study.
abstract: OBJECTIVE
  Atherosclerotic heart diseases are less frequently seen in patients with Gilbert's syndrome (GS). We aimed to investigate whether serum adiponectin (APN) and epicardial adipose tissue (EAT) thickness have an effect beside the antioxidant effect of bilirubin in lowering the incidence of the atherosclerotic process.
  
  
  METHODS
  Sixty-eight patients diagnosed with GS (39 females and 29 males) who had applied at the internal medicine clinic of the hospital were included in this cross-sectional, observational study. The control group included 63 healthy people (39 females and 24 males). EAT thickness was measured by echocardiography. The serum APN levels were also checked. Statistical analysis was performed by using independent sample t-test, Pearson correlation and linear regression analyses.
  
  
  RESULTS
  The mean age of the GS group was 28 ± 9 years, and the average EAT thickness was found to be 2.5 ± 0.1 mm. The mean age of the control group was 26 ± 6 years, and the average EAT thickness was found to be 4.2 ± 0.5 mm. When comparing the two groups, the EAT thickness of the GS group was found to be significantly lower (p<0.001) than that of the control group. In the GS group the APN was 14.9 ± 4.2 mg/L, and in the control group the APN was 12.6 ± 4.5 mg/L (p<0.022). We found that total bilirubin (β=-1,607, p<0,001) and indirect bilirubin (β=1,086, p<0,001) have an independent association with decreased EAT thickness.
  
  
  CONCLUSIONS
  EAT thickness is associated with coronary atherosclerosis. Low EAT thickness may be related with low release of proinflammatory cytokine. High levels of APN may be related high anti-inflammatory effect. Therefore, low EAT thickness and high levels of APN may demonstrate protective effect on atherosclerotic heart diseases in GS patients.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize-Turkey. erkancure@yahoo.com.
authors.forename: Erkan
authors.initials: E
authors.lastname: Cüre
authors.forename: Yüksel
authors.initials: Y
authors.lastname: Ciçek
authors.forename: Medine
authors.initials: M
authors.lastname: Cumhur Cüre
authors.forename: Süleyman
authors.initials: S
authors.lastname: Yüce
authors.forename: Aynur
authors.initials: A
authors.lastname: Kırbaş
authors.forename: Arif
authors.initials: A
authors.lastname: Yılmaz
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000273:Adipose Tissue / Q000000981:diagnostic imaging*; D000328:Adult; D001663:Bilirubin / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005878:Gilbert Disease / Q000097:blood / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010496:Pericardium / Q000000981:diagnostic imaging*; D014463:Ultrasonography
chemical_list: D052242:Adiponectin; D001663:Bilirubin