title: Mildly elevated serum total bilirubin levels are negatively associated with carotid atherosclerosis among elderly persons with type 2 diabetes.
abstract: Diabetes is strongly associated with several mechanisms of tissue damage such as oxidative stress. Serum bilirubin may have a beneficial role in preventing oxidative changes in cardiovascular disease (CVD). Limited information is available on whether serum bilirubin is an independent confounding factor for carotid atherosclerosis among elderly persons with type 2 diabetes. The study subjects were 169 men aged 79 ± 8 (mean ± SD) years and 205 women aged 81 ± 8 years that were enrolled consecutively from patients in the medical department. Carotid intima-media thickness (IMT) and plaque were derived via B-mode ultrasonography. Multiple linear regression analysis showed that serum total bilirubin (β = -0.160) was significantly associated with carotid IMT. Compared to subjects with a serum total bilirubin of tertile-1 (0.13-0.58 mg/dL), the multivariate-adjusted odds ratio (95% confidence interval) of carotid IMT ≥1.0 mm including plaque and carotid plaque was 0.46 (0.23-0.93) and 0.32 (0.17-0.60) in the Tertile-3 group (0.87-1.93 mg/dL), respectively. Next, data were further stratified by gender, age, smoking status, medication and prevalence of CVD. There were no significant differences in serum total bilirubin levels between selected subgroups. Our data demonstrated a negative association between serum total bilirubin and carotid atherosclerosis among elderly persons with type 2 diabetes.
authors.affiliation: a Department of Community Medicine , Ehime University Graduate School of Medicine , Ehime , Japan and.|b Department of Internal Medicine , Seiyo Municipal Nomura Hospital , Ehime , Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Kawamoto
authors.affiliation: a Department of Community Medicine , Ehime University Graduate School of Medicine , Ehime , Japan and.|b Department of Internal Medicine , Seiyo Municipal Nomura Hospital , Ehime , Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ninomiya
authors.affiliation: a Department of Community Medicine , Ehime University Graduate School of Medicine , Ehime , Japan and.|b Department of Internal Medicine , Seiyo Municipal Nomura Hospital , Ehime , Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: b Department of Internal Medicine , Seiyo Municipal Nomura Hospital , Ehime , Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kasai
authors.affiliation: b Department of Internal Medicine , Seiyo Municipal Nomura Hospital , Ehime , Japan.
authors.forename: Tomo
authors.initials: T
authors.lastname: Kusunoki
authors.affiliation: b Department of Internal Medicine , Seiyo Municipal Nomura Hospital , Ehime , Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Ohtsuka
authors.affiliation: a Department of Community Medicine , Ehime University Graduate School of Medicine , Ehime , Japan and.
authors.forename: Teru
authors.initials: T
authors.lastname: Kumagi
authors.affiliation: a Department of Community Medicine , Ehime University Graduate School of Medicine , Ehime , Japan and.
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood*; D002340:Carotid Artery Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness; D015897:Comorbidity; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D016017:Odds Ratio; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods
chemical_list: D001663:Bilirubin
keywords: Atherosclerosis; Serum total bilirubin; carotid artery; confounding factor; type 2 diabetes; ultrasonography