title: Inverse association between serum bilirubin levels and arterial stiffness in Korean women with type 2 diabetes.
abstract: BACKGROUND
  Considerable evidence suggests that bilirubin is a potent physiologic antioxidant that may provide important protection against cardiovascular disease (CVD) and inflammation. We investigated the relationship between serum total bilirubin (TB) levels and arterial stiffness, measured by the brachial-ankle pulse wave velocity (baPWV), in patients with type 2 diabetes.
  
  
  METHODS
  We conducted a cross-sectional analysis of 1,711 subjects with type 2 diabetes (807 men and 904 women; mean age, 57.1 years). The subjects were stratified based on gender-specific tertiles of TB values, and a high baPWV was defined as greater than 1,745 cm/s ( >75th percentile).
  
  
  RESULTS
  The serum TB concentration was negatively correlated with the duration of diabetes, HbA1c, the 10-year Framingham risk score, and baPWV and was positively correlated with high-density lipoprotein cholesterol and the eGFR in both genders. Inverse association between TB categories and unadjusted prevalence of high PWV was only observed in women. After adjusting for confounding factors, the TB levels were inversely associated with a greater risk of a high baPWV, both as a continuous variable [a 1-SD difference; odds ratio (OR), 0.70; 95% confidence interval (CI), 0.54-0.90; P = 0.005] and when categorized in tertiles (the highest vs. the lowest tertile; OR, 0.49; 95% CI, 0.28-0.85; P = 0.011) in women but not in men. The relationship remained significant even after adjusting for retinopathy and nephropathy.
  
  
  CONCLUSIONS
  Low TB levels were significantly associated with arterial stiffness in Korean women with type 2 diabetes. Our data suggested that bilirubin may protect against macrovascular disease in diabetic women.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; The Catholic University of Korea Incheon St. Mary's hospital, Incheon, Korea.
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; The Catholic University of Korea Incheon St. Mary's hospital, Incheon, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Mo
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; The Catholic University of Korea Incheon St. Mary's hospital, Incheon, Korea.
authors.forename: Sung Dae
authors.initials: SD
authors.lastname: Moon
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; The Catholic University of Korea Incheon St. Mary's hospital, Incheon, Korea.
authors.forename: Je Ho
authors.initials: JH
authors.lastname: Han
mesh_terms: D000842:Ankle / Q000502:physiology; D055109:Ankle Brachial Index / Q000379:methods; D001158:Arteries / Q000503:physiopathology*; D044466:Asian People; D001663:Bilirubin / Q000097:blood*; D001783:Blood Flow Velocity / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000502:physiology; D063177:Pulse Wave Analysis / Q000379:methods; D012307:Risk Factors; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D008076:Cholesterol, HDL; D001663:Bilirubin