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Editorial |
1 Clinical Research, Wilford Hall Medical Center, Lackland AFB, TX 78236, Fax 210-292-6053, E-mail schwertner@lackland.af.mil
| The first 20% of the full text of this article appears below. |
An inverse association between serum bilirubin and cardiovascular disease has been shown in numerous retrospective and prospective studies (1)(2)(3)(4)(5)(6)(7)(8) as well as in a metaanalysis study (9). Schwertner et al. (1) first reported that fasting serum bilirubin concentrations are inversely related to coronary artery stenosis in men. Low serum bilirubin concentrations were found to be associated with an increased risk of coronary artery disease (CAD), whereas bilirubin concentrations near the upper end of the reference interval were associated with a low risk of CAD. The strength of the association between bilirubin and CAD was similar to that of smoking, systolic blood pressure, and HDL-cholesterol.
Hopkins et al. (2) confirmed the findings in a retrospective case-controlled study of men and women with early familial CAD. Individuals in the top quintile of serum bilirubin concentrations had an 80% reduction in CAD risk compared with individuals in the lowest quintile. Low bilirubin concentrations also have been found in individuals with peripheral vascular disease (PVD) (3) and ischemic heart disease (IHD) (6)(7)(8).
Several prospective studies have shown that low serum bilirubin predicts future cardiovascular disease. In 1995, Breimer et al. (6) performed a prospective study of 7685 middle-aged men enrolled in the British Regional Heart Study (BRHS) and found that both low and high bilirubin concentrations were associated with an increased risk of CAD. In a prospective study of serum bilirubin and myocardial infarction (MI) in the Framingham Offspring Study (7
Protective Effect of Increased Bilirubin Concentrations
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C.-S. Ki, K.-A Lee, S.-Y. Lee, H.-J. Kim, S. S. Cho, J.-H. Park, S. Cho, K. M. Sohn, and J.-W. Kim Haplotype Structure of the UDP-Glucuronosyltransferase 1A1 (UGT1A1) Gene and Its Relationship to Serum Total Bilirubin Concentration in a Male Korean Population Clin. Chem., December 1, 2003; 49(12): 2078 - 2081. [Full Text] [PDF] |
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