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. 2014 Oct 9;9(10):e109251.
doi: 10.1371/journal.pone.0109251. eCollection 2014.

Inverse association between serum bilirubin levels and arterial stiffness in Korean women with type 2 diabetes

Eun Sook Kim  1 , Eun Young Mo  1 , Sung Dae Moon  1 , Je Ho Han  1
Affiliations

Inverse association between serum bilirubin levels and arterial stiffness in Korean women with type 2 diabetes

Eun Sook Kim et al. PLoS One. .

Abstract

Background: Considerable evidence suggests that bilirubin is a potent physiologic antioxidant that may provide important protection against cardiovascular disease (CVD) and inflammation. We investigated the relationship between serum total bilirubin (TB) levels and arterial stiffness, measured by the brachial-ankle pulse wave velocity (baPWV), in patients with type 2 diabetes.

Methods: We conducted a cross-sectional analysis of 1,711 subjects with type 2 diabetes (807 men and 904 women; mean age, 57.1 years). The subjects were stratified based on gender-specific tertiles of TB values, and a high baPWV was defined as greater than 1,745 cm/s ( >75th percentile).

Results: The serum TB concentration was negatively correlated with the duration of diabetes, HbA1c, the 10-year Framingham risk score, and baPWV and was positively correlated with high-density lipoprotein cholesterol and the eGFR in both genders. Inverse association between TB categories and unadjusted prevalence of high PWV was only observed in women. After adjusting for confounding factors, the TB levels were inversely associated with a greater risk of a high baPWV, both as a continuous variable [a 1-SD difference; odds ratio (OR), 0.70; 95% confidence interval (CI), 0.54-0.90; P = 0.005] and when categorized in tertiles (the highest vs. the lowest tertile; OR, 0.49; 95% CI, 0.28-0.85; P = 0.011) in women but not in men. The relationship remained significant even after adjusting for retinopathy and nephropathy.

Conclusions: Low TB levels were significantly associated with arterial stiffness in Korean women with type 2 diabetes. Our data suggested that bilirubin may protect against macrovascular disease in diabetic women.

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Conflict of interest statement

Competing Interests: The authors have the following interests: This study was supported by AJU Pharmaceutical Co. Ltd. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. Unadjusted prevalence of a high PWV according to serum TB levels in men and women.
aby χ2 test over the three groups; * P<0.05 vs. T1 (TB <0.60 mg/dL), # P<0.05 vs. T2 (TB 0.60–0.70 mg/dL).
See this image and copyright information in PMC

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Grants and funding

This study was supported by AJU Pharmaceutical Co. Ltd. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.