Association between bilirubin and lipid profile in Portuguese elderly individuals
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abstract
Several studies showed that mildly elevated bilirubin blood concentration is inversely associated to coronary artery
disease (CAD). The most commonly mechanism contributing to CAD prevention is the bilirubin antioxidant
effect, protecting several macromolecules from oxidation. Recently, other studies have found that higher
serum bilirubin levels (BL) are associated with beneficial effects improving lipid profile and that might
contribute to decrease cholesterol and triacylglycerol. In the meantime, a consistently negative association
between BL and body mass index (BMI) was observed.
The aim of this study was evaluate the cardiovascular risk protection by bilirubin analyzing the association
between bilirubin levels and lipid profile in elderly. Clinical data, anthropometric measurements (BMI,
Visceral Fat and Body Fat Percentage), lipid profile (total cholesterol-TC; triglycerides-TG; high-density
lipoprotein cholesterol-HDL-c; low-density lipoprotein cholesterol-LDL-c; apoliprotein A-Apo-A;
apoliprotein B-Apo-B) were evaluated in 70 institutionalized elderly, 43 females (mean age= 88.2±5.5
years old) and 27 males (mean age= 87.7±7.7 years old). Anthropometric measurements were obtained
by bioimpedance, using specific scale (Tanita BC Model: 545). The lipid parameters were performed in
autoanalyzer (Cobas Mira S, Roche, Switzerland) using available commercial kits.
Correlation analysis revealed positive associations between BL and the HDL-c in males (total bilirubin:
r=0.51; p<0.007) and no association in females (r=0.40; p<0.50). Positive associations were also found to
TB levels and Apo-A (males: r=0.40; p<0.50 and females: r=0.270; p<0.013).
Interestingly, the conjugated bilirubin present a stronger positive association with this two parameters
(male: r=0.64; p<0.000; female: r=0.29; p<0.052).
No associations were found between bilirubin and triglycerides; total cholesterol and anthropometric
measurements.
Low levels of HDL-c are a risk factor for coronary heart disease. A similar association has been shown for
Apo-A1.
These results suggest higher bilirubin is associated with higher cardioprotective agents, which indicates
that the determination of total bilirubin should be included for more accurate cardiovascular disease risk
assessment.
