Key result
Higher serum total bilirubin levels (0.87-1.93 mg/dL) were associated with lower odds of carotid IMT ≥1.0 mm (OR 0.46; 95% CI 0.23-0.93) in elderly patients with type 2 diabetes.
Why the study?
Are higher serum total bilirubin levels associated with reduced carotid atherosclerosis in elderly persons with type 2 diabetes?
Cross-Sectional (n=374)
Are higher serum total bilirubin levels associated with reduced carotid atherosclerosis in elderly persons with type 2 diabetes?
Odds Ratio: 0.46 (95% CI 0.23–0.93)
Mildly elevated serum total bilirubin levels are independently associated with a lower prevalence of carotid atherosclerosis in elderly patients with type 2 diabetes.
Should not change practice in elderly T2D; leaves causal role and therapeutic implications open.
Diabetes is strongly associated with several mechanisms of tissue damage such as oxidative stress. Serum bilirubin may have a beneficial role in preventing oxidative changes in cardiovascular disease (CVD). Limited information is available on whether serum bilirubin is an independent confounding factor for carotid atherosclerosis among elderly persons with type 2 diabetes. The study subjects were 169 men aged 79 ± 8 (mean ± SD) years and 205 women aged 81 ± 8 years that were enrolled consecutively from patients in the medical department. Carotid intima-media thickness (IMT) and plaque were derived via B-mode ultrasonography. Multiple linear regression analysis showed that serum total bilirubin (β = -0.160) was significantly associated with carotid IMT. Compared to subjects with a serum total bilirubin of tertile-1 (0.13-0.58 mg/dL), the multivariate-adjusted odds ratio (95% confidence interval) of carotid IMT ≥1.0 mm including plaque and carotid plaque was 0.46 (0.23-0.93) and 0.32 (0.17-0.60) in the Tertile-3 group (0.87-1.93 mg/dL), respectively. Next, data were further stratified by gender, age, smoking status, medication and prevalence of CVD. There were no significant differences in serum total bilirubin levels between selected subgroups. Our data demonstrated a negative association between serum total bilirubin and carotid atherosclerosis among elderly persons with type 2 diabetes.
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Kawamoto et al. (2015) conducted a cross-sectional in Type 2 diabetes (n=374). Serum total bilirubin vs. Tertile-1 (0.13-0.58 mg/dL) was evaluated on Carotid IMT ≥1.0 mm including plaque (OR 0.46, 95% CI 0.23-0.93). Higher serum total bilirubin levels (0.87-1.93 mg/dL) were associated with lower odds of carotid IMT ≥1.0 mm (OR 0.46; 95% CI 0.23-0.93) in elderly patients with type 2 diabetes.
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