Tuesday, October 26, 2010

Is hyperbilirubinemia protective ?

Well..a mild increase in unconjugated bilirubin may be a good thing to have!. Iam talking about patients with Gilbert's syndrome(GS) and patients with a mild elevation in their indirect bilirubin in the absence of liver disease. GS is a benign syndrome cause by reduced activity of enzyme UDP Glucronyl Transferase. In one of the famous prospective cohort studies- The British Regional Heat Study(BRHS) there was a U shaped relationship between bilirubin level and heart disease. Men with low bilirubin levels were found to have low concentrations of HDL cholesterol, low FEV1, and low serum albumin. This led to a small study in Univ of Utah...which showed a similar inverse relationship between bilirubin & heart disease.Another prospective study from Europe called PRIME study involving 10,000 men also showed that a slightly elevated bilirubin is a marker of protection against Coronary Heart Disease. Another strong pointer towards this trend is the lesser incidence of heart disease in patients with Gilbert's syndrome compared to general population (Atherosclerosis 2002)


This benefit has been explained on the basis of the antioxidant property of Bilirubin. It might prevent oxygen radicals from damaging the endothelium, and it also prevents oxidation of LDL particles. Bot these effects can explain a lower incidence of Ischemic heart disease in this population. Well....if this idea is true....then it should protect against stoke as well. 


Stroke & bilirubin - A 30% risk reduction in incidence of carotid plaques was found in patients with their bilirubin the highest quartile compared to bilirubin in lowest quartile (Stoke 2001).  recent study published in Stroke 2009 ...studying nearly 80,000 healthy patients showed a 20% risk reduction in ISCHEMIC stroke in patients with high bilirubin levels.
Aaand...it doesnt stop here! Another study from Annals of Hepatology published in 2008 showed that a 0.1 mg/dL increase in bilirubin level was associated with a 6% reduction in the odds of peripheral vascular disease (PAD). The benefit was noticed more in men than women. Another article in JAMA 2007 comparing diabetic pts with Gilbert's syndrome to normal people...showed a a significantly lower prevalence of hypertension, HbA1c, LDLl, total cholesterol, and triglyceride,CRP and higher levels of HDL. They also had a lower incidence of proteinuria as well (have a look at the table). Very recently ,an article in Kidney International (Oct 2010) shows that in rats who had hereditary hyperbilirubnemia had lower incidence of diabetic nephropathy.


It may be difficult to prove whether high bilirubin is an effect of body's need for an antioxidant...or it does genuinely protect against atherosclerosis. But bilirubin seems to offer a definite protection, and could be used as a reasonably good marker of vascular events. The main hindrance to bilirubin's use is that we cannot modify its level...to attain any of these benefits. A level just around upper limit of normal( upto 2.5 x normal in GS) would be the level talked about in the studies.

18 comments:

  1. Sometimes funny pictures are created automatically, and now need a little time to our own.
    If you have wandered around the internet to any
    extent you have probably encountered funny pictures.
    simply keep in mind few websites that may lead you to fun and smiles
    on face.

    Also visit my web blog - lol pictures

    ReplyDelete
  2. Your payments will not only get to you faster but it will provide you with a history of your earnings
    for your records. The reason this is important is because
    you will have a stronger knowledge base and bag of tricks to keep you
    going on the rougher days. ' Being physically active can promote good mental health and help you to manage stress, anxiety and depression.

    My weblog ... http://articlesfind.com/Exploring-Fitness-Tips-Plans.htm

    ReplyDelete
  3. Here again you want to find or even create an angle or slant in which you can take headline
    news and 'incorporate' it into a post you are composing.

    However there are several troubleshooting steps you need to perform in order to determine the problem.
    However, today, the wedding photographers capture photographs of moments that are
    precious and that you would cherish all your life; and, when you least
    expects the wedding photographer to capture you.



    Here is my site: shiatsu-massagechairs.org

    ReplyDelete
  4. If you have a website, you can use Google Trends for your website
    traffic to increase as well. Researches have also found the Broccoli also
    contains necessary enzymes such as myrosinase in it.
    I want to mention a part of the Prime Law (Twelve Visions Party) which is part of Neothink.



    Look into my blog post eoee.ir

    ReplyDelete
  5. I've listened to this a dozen or more times and still find it delightful and sooooo original in concept. I have more stuffings in me from yesterday than I care to think about. You can only visit once a day and there is no guarantee that you will get anything from it but as I always say, free is free.

    Review my blog :: Latest Daily News

    ReplyDelete
  6. Vanity Fair is stylish and well written, and they push the envelope in celebrity reporting, giving readers if not a balanced representation, then
    at least an interesting angle to a well known personality.
    Women who are planning the wedding of their dreams can find plenty
    of fantastic information in Bride’s magazine. He covers
    gossip on celebrities, actors and musicians.

    Here is my weblog; latest celeb news

    ReplyDelete
  7. Countless teenage parties have been spiced up by this funny little game, and countless adolescent mischiefs have amused millions of young people.
    But my favorite is the link that tells you
    about bad dates stories, of course they are the funniest.

    While wasting your time watching something marginally funny may actually frustrate you, watching truly hilarious movies and shows is an easy way to
    get laughter into your life whenever you need it.



    Also visit my web-site ... really funny pictures and sayings

    ReplyDelete
  8. Hello, Neat post. There is an issue with your web site in web explorer,
    would check this? IE still is the market chief and a big
    part of other people will pass over your wonderful writing
    due to this problem.

    my blog post Testoril Male Supplements

    ReplyDelete
  9. Hello there! I just would like to give you a huge thumbs up for the
    excellent info you have got right here on this post.
    I am coming back to your website for more soon.

    Here is my web site; latest world news

    ReplyDelete
  10. I am regular visitor, how are you everybody? This article posted at this website is truly fastidious.


    Visit my webpage - akribos xxiv watches for women

    ReplyDelete
  11. Hi, i read your blog from time to time and i own a similar one and i was just wondering if you get a lot of spam remarks?
    If so how do you reduce it, any plugin or anything you can suggest?
    I get so much lately it's driving me crazy so any support is very much appreciated.

    Look into my web site Test Force Xtreme Muscle

    ReplyDelete
  12. Normally I do not learn post on blogs, but I wish to say that this write-up very forced me
    to check out and do so! Your writing taste has been amazed
    me. Thank you, very nice post.

    Look at my weblog - Online Home Careers Scam

    ReplyDelete
  13. Yes! Finally something about to make.

    Also visit my site raspberry ketone

    ReplyDelete
  14. This is excellent. I've heard this theory recently but this is very detailed. Kudos

    my web blog :: http://cost96wilber.busythumbs.com/entry_id/713281/action/viewentry/

    ReplyDelete
  15. maggie.danhakl@healthline.comSeptember 20, 2014 at 9:12 AM

    Hi,

    Healthline recently put together an infograph showcasing heart disease statistics and facts to help someone understand their risk for a heart attack or other heart-related issues. You can see the infograhic here: http://www.healthline.com/health/heart-disease-infographic

    I am writing to you to see if you can help spread awareness about heart disease by sharing this with your followers or including it as a resource on your page: http://medicineforresidents.blogspot.com/2010/10/is-hyperbilirubinemia-protective.html

    Please let me know if you would be interested in helping to raise awareness about heart disease.

    Thank you for your time reviewing. Please let me know if there are any questions I can answer.

    Warm regards,
    Maggie Danhakl • Assistant Marketing Manager
    p: 415-281-3124 f: 415-281-3199

    Healthline • The Power of Intelligent Health
    660 Third Street, San Francisco, CA 94107
    www.healthline.com | @Healthline | @HealthlineCorp

    About Us: corp.healthline.com

    ReplyDelete