title: Total Bilirubin Levels Predict Subclinical Atherosclerosis in Patients With Prediabetes.
abstract: Bilirubin may have important antiatherosclerotic effects. Prediabetes (PD), the intermediate stage before diabetes mellitus, is associated with increased cardiovascular morbidity and mortality. We evaluated the relationship between serum bilirubin levels and carotid intima-media thickness (cIMT), as a surrogate marker of subclinical atherosclerosis, in patients with PD. We enrolled 170 consecutive patients with PD. The patients underwent ultrasonography to evaluate cIMT. The patients were divided into groups according to cIMT values (<0.9 vs ≥0.9 mm). The patients with cIMT ≥ 0.9 mm had significantly higher diastolic blood pressure, neutrophil-lymphocyte ratio (NLR), and glycated hemoglobin values compared with patients having cIMT < 0.9 mm, whereas total and direct bilirubin values were significantly lower in this group. Multivariate regression analyses revealed NLR and total bilirubin as the independent predictors of subclinical atherosclerosis. The present study demonstrated that NLR and lower total bilirubin levels were independent predictors of subclinical atherosclerosis in patients with PD. Simple measures such as NRL and total bilirubin may provide predictive information regarding the risk of cardiovascular disease in patients with PD.
authors.affiliation: 1 Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Hikmet
authors.initials: H
authors.lastname: Hamur
authors.affiliation: 2 Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Duman
authors.affiliation: 3 Department of Internal Medicine, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Levent
authors.initials: L
authors.lastname: Demirtas
authors.affiliation: 1 Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Eftal Murat
authors.initials: EM
authors.lastname: Bakirci
authors.affiliation: 2 Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.
authors.forename: Murtaza Emre
authors.initials: ME
authors.lastname: Durakoglugil
authors.affiliation: 1 Department of Cardiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
authors.forename: Husnu
authors.initials: H
authors.lastname: Degirmenci
authors.affiliation: 4 Department of Cardiology, Training and Research Hospital, Erzurum, Turkey.
authors.forename: Kamuran
authors.initials: K
authors.lastname: Kalkan
authors.affiliation: 4 Department of Cardiology, Training and Research Hospital, Erzurum, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Yildirim
authors.affiliation: 5 Department of Cardiology, Dr. Ersin Arslan State Hospital, Gaziantep, Turkey.
authors.forename: Ertan
authors.initials: E
authors.lastname: Vuruskan
mesh_terms: D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000097:blood*; D001663:Bilirubin / Q000097:blood*; D001794:Blood Pressure / Q000502:physiology; D059168:Carotid Intima-Media Thickness; D048909:Diabetes Complications / Q000097:blood*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000276:immunology; D011236:Prediabetic State / Q000097:blood*; D011237:Predictive Value of Tests; D012306:Risk
chemical_list: D001663:Bilirubin
keywords: bilirubin; carotid intima–media thickness; prediabetes; subclinical atherosclerosis