title: Mildly elevated serum bilirubin levels are negatively associated with carotid atherosclerosis among elderly persons.
abstract: Serum bilirubin may have a beneficial role in preventing oxidative changes in atherosclerosis. Limited information is available on whether serum total bilirubin is an independent confounding factor for carotid atherosclerosis {for example, intima-media thickness (IMT), plaque} measured noninvasively by B-mode ultrasonography only among elderly persons. The study subjects were 325 men aged 79 ± 8 (mean ± standard deviation) years and 509 women aged 81 ± 8 years that were enrolled consecutively from patients aged ≥ 60 years in the medical department. Carotid IMT and plaque were derived via B-mode ultrasonography. Multiple linear regression analysis showed that in men age (β = 0.199, p = 0.002), smoking status (β = 0.154, p = 0.006), GGT (β = -0.139, p = 0.039), and GGT (β = -0.133, p = 0.022) were significantly and independently associated with carotid IMT, and in women age (β = 0.186, p < 0.001), systolic blood pressure (β = 0.104, p = 0.046), diastolic blood pressure (β = -0.148, p = 0.004), prevalence of antihypertensive medication (β = 0.126, p = 0.004), fasting plasma glucose (β = 0.135, p = 0.003), GGT (β = -0.104, p = 0.032), estimated glomerular filtration rate, serum bilirubin (β = -0.119, p = 0.006), and prevalence of cardiovascular disease (CVD) (β = 0.103, p = 0.017) were also independently associated with carotid IMT. The odds ratios (ORs) {95% confidence interval (CI)} of increasing serum bilirubin category were negatively associated with carotid IMT ≥ 1.0 mm and plaque in both genders. Compared to subjects with a serum bilirubin of Quartile-1, the multivariate-OR (95% CI) of carotid plaque was 0.25 (0.11-0.57) in the Quartile-4 male group, and 0.41 (0.21-0.78) in the Quartile-2 female group, 0.51 (0.26-0.98) in the Quartile-3 female group, and 0.46 (0.24-0.89) in the Quartile-4 female group. Our data demonstrated an independently negative association between serum bilirubin and carotid atherosclerosis in both genders.
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kawamoto
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ninomiya
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan; Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kasai
authors.affiliation: Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Tomo
authors.initials: T
authors.lastname: Kusunoki
authors.affiliation: Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohtsuka
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Teru
authors.initials: T
authors.lastname: Kumagi
authors.affiliation: Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood*; D001794:Blood Pressure / Q000502:physiology; D002339:Carotid Arteries / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000097:blood* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking
chemical_list: D001663:Bilirubin