Serum bilirubin is inversely associated with insulin resistance and metabolic syndrome among children and adolescents

• Published in: Atherosclerosis 2009-04, Vol.203 (2), p.563-568
• Main Authors: Lin, Lian-Yu, Kuo, Hsu-Ko, Hwang, Juey-Jen, Lai, Ling-Ping, Chiang, Fu-Tien, Tseng, Chuen-Den, Lin, Jiunn-Lee
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescents; Antioxidants - metabolism; Atherosclerosis (general aspects, experimental research); Bilirubin; Bilirubin - blood; Bilirubin - chemistry; Biological and medical sciences; Blood and lymphatic vessels; C-Reactive Protein - biosynthesis; Cardiology. Vascular system; Cardiovascular; Child; Children; Cohort Studies; Cross-Sectional Studies; Female; Humans; Inflammation; Injuries of the limb. Injuries of the spine; Insulin Resistance; Male; Medical sciences; Metabolic syndrome; Metabolic Syndrome - blood; Odds Ratio; Prevalence; Traumas. Diseases due to physical agents
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2008.07.021

Abstract Objective Bilirubin is a potent antioxidant and a cyroprotectant. Low serum bilirubin is associated with atherosclerosis. Little is known about its role in metabolic syndrome (MS) among children and adolescents. Methods We examined 4723 children and adolescents aged 12–17 years with reliable measures of various serum hepatic profiles and metabolic risks from Health and Nutrition Examination Survey 1999–2004. Results The results showed that the prevalence of the MS was from 6.6 ± 1.2% in the lowest quartile to 2.1 ± 1.9% in the highest quartile of the concentration of total bilirubin. The graded association remained significant after the adjustment of other co-variates. The odds ratios for the MS were around 0.29 (0.08–0.99) and 0.23 (0.08–0.65) for the upper two quartiles when using the lowest quartile as reference for the concentration of total bilirubin. The quartiles of the serum total bilirubin levels were inversely correlated with the homeostasis model assessment (HOMA-IR) and insulin while not associated with the serum C-reactive protein (CRP) levels. Conclusions The serum total bilirubin levels are inversely correlated with the prevalence of the MS. The mechanism of the association between MS and total bilirubin may be related to the insulin resistance status.