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Relation of conjugated bilirubin concentrations to the presence of coronary artery calcium

Relation of conjugated bilirubin concentrations to the presence of coronary artery calcium
Relation of conjugated bilirubin concentrations to the presence of coronary artery calcium
Whether conjugated bilirubin concentration, resulting from hepatic UDP-glucuronosyltransferase 1 A1 activity, is associated with cardiovascular disease is unknown. Our aim was to investigate the relation between serum conjugated bilirubin concentrations and coronary artery calcium score (CACS) as a measure of preclinical atherosclerosis. Data were analyzed from an occupational cohort of 14,583 subjects who underwent a cardiac computed tomographic estimation of CACS and measurements of risk factors. Logistic regression was used to describe associations between bilirubin concentrations and CACS. The proportion of subjects with a CACS >0 (total: men = 1,351, women = 111) decreased across increasing conjugated bilirubin quartiles (men p <0.001, women p = 0.005). After adjustment for age, gender, waist, systolic blood pressure, smoking, exercise, alcohol, homeostatic model assessment of insulin resistance, glucose, triglyceride, high- and low-density lipoprotein cholesterols, high-sensitivity C-reactive protein, lipoprotein (a), ferritin, fatty liver, cerebrovascular accident, coronary artery disease, hypertension, and diabetes, there was an inverse independent association between conjugated bilirubin and CACS >0 (odds ratio 0.76, 95% confidence interval 0.64 to 0.92, p = 0.004, for top vs bottom quartile). After further adjustment for estimated glomerular filtration rate, the odds ratio was 0.83 (95% confidence interval 0.69 to 0.99), p = 0.04. Exclusion of subjects with a high bilirubin (total >1.3 mg/dl) did not attenuate the association. In conclusion, there was a strong inverse and independent relation between conjugated bilirubin and CACS. The mechanism behind this association is not clear and may not be causal, but the effects of glucuronidation on cardiovascular disease risk should be tested.
0002-9149
1873-1879
Sung, Ki-Chul
a4318faa-ffbe-4206-b7aa-285768065c01
Shin, Jinho
d3569616-0cd6-4cec-acd2-4677986ea578
Lim, Young-Hyo
696d36c9-d87a-4dfc-aecc-6136ffcc688c
Wild, Sarah H.
b790195a-4aae-421b-81f7-2c18c96e6870
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Sung, Ki-Chul
a4318faa-ffbe-4206-b7aa-285768065c01
Shin, Jinho
d3569616-0cd6-4cec-acd2-4677986ea578
Lim, Young-Hyo
696d36c9-d87a-4dfc-aecc-6136ffcc688c
Wild, Sarah H.
b790195a-4aae-421b-81f7-2c18c96e6870
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c

Sung, Ki-Chul, Shin, Jinho, Lim, Young-Hyo, Wild, Sarah H. and Byrne, Christopher D. (2013) Relation of conjugated bilirubin concentrations to the presence of coronary artery calcium. The American Journal of Cardiology, 112 (12), 1873-1879. (doi:10.1016/j.amjcard.2013.08.018). (PMID:24063841)

Record type: Article

Abstract

Whether conjugated bilirubin concentration, resulting from hepatic UDP-glucuronosyltransferase 1 A1 activity, is associated with cardiovascular disease is unknown. Our aim was to investigate the relation between serum conjugated bilirubin concentrations and coronary artery calcium score (CACS) as a measure of preclinical atherosclerosis. Data were analyzed from an occupational cohort of 14,583 subjects who underwent a cardiac computed tomographic estimation of CACS and measurements of risk factors. Logistic regression was used to describe associations between bilirubin concentrations and CACS. The proportion of subjects with a CACS >0 (total: men = 1,351, women = 111) decreased across increasing conjugated bilirubin quartiles (men p <0.001, women p = 0.005). After adjustment for age, gender, waist, systolic blood pressure, smoking, exercise, alcohol, homeostatic model assessment of insulin resistance, glucose, triglyceride, high- and low-density lipoprotein cholesterols, high-sensitivity C-reactive protein, lipoprotein (a), ferritin, fatty liver, cerebrovascular accident, coronary artery disease, hypertension, and diabetes, there was an inverse independent association between conjugated bilirubin and CACS >0 (odds ratio 0.76, 95% confidence interval 0.64 to 0.92, p = 0.004, for top vs bottom quartile). After further adjustment for estimated glomerular filtration rate, the odds ratio was 0.83 (95% confidence interval 0.69 to 0.99), p = 0.04. Exclusion of subjects with a high bilirubin (total >1.3 mg/dl) did not attenuate the association. In conclusion, there was a strong inverse and independent relation between conjugated bilirubin and CACS. The mechanism behind this association is not clear and may not be causal, but the effects of glucuronidation on cardiovascular disease risk should be tested.

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More information

e-pub ahead of print date: 21 September 2013
Published date: 15 December 2013
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 360773
URI: http://eprints.soton.ac.uk/id/eprint/360773
ISSN: 0002-9149
PURE UUID: b1ec05e4-fbdf-46d5-9577-98c4ad5a9ef2
ORCID for Christopher D. Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 02 Jan 2014 12:38
Last modified: 23 Jul 2022 01:45

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Contributors

Author: Ki-Chul Sung
Author: Jinho Shin
Author: Young-Hyo Lim
Author: Sarah H. Wild

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