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Objective@# To learn the interaction of serum direct bilirubin and blood lipids on the risk of carotid atherosclerosis and carotid plaque.@*Methods @#The subjects were selected from Hangzhou Wuyunshan Sanatorium from March 2016 to December 2018. Demographic information,laboratory testing results and carotid intima-media thickness（IMT）were collected. The logistic regression model was employed for the association of direct bilirubin,blood lipids and their interaction with the risk of carotid atherosclerosis and carotid plaque. @*Results@#Totally 8 308 subjects were recruited. Among them,616（7.41%） subjects had carotid atherosclerosis,and 2 409（29.00%）subjects had plaques. The results of multivariate and multinomial logistic regression analysis showed that high level of direct bilirubin was associated with decreased risks of carotid atherosclerosis（OR=0.701,95%CI：0.537-0.916）and carotid plaque（OR=0.647,95%CI：0.527-0.795）;high TC level（OR=1.335,95% CI：1.106-1.611）, high LDL-C level（OR=1.338,95%CI：1.098-1.629）and low HDL-C level（OR=1.431,95%CI：1.148-1.783）were associated with increased risks of carotid atherosclerosis;high TC level（OR=1.325,95% CI：1.151-1.525）and high LDL-C（OR=1.311,95%CI：1.130-1.520）were associated with increased risks of carotid plaque. There were interactions between direct bilirubin and TC or LDL-C on the risk of carotid plaque（P<0.05）. Compared with the subjects with high level of direct bilirubin and normal level of TC,the subjects with normal level of direct bilirubin and high level of TC had significantly higher risk of carotid plaque（OR=1.831,95%CI：1.438-2.333）;compared with the subjects with high level of direct bilirubin and normal level of LDL-C,the subjects with normal level of direct bilirubin and high level of LDL-C had significantly higher risk of carotid plaque（OR=1.814,95%CI：1.427-2.306）.@*Conclusion @#The interactions between direct bilirubin and TC or LDL-C increase the risk of carotid plaque. It is important to strengthen blood lipid control in the patients with normal level of direct bilirubin and hyperlipidemia.
ABSTRACT
Objective: To investigate the relationship between Bilirubin blood lipid comprehensive index and ifbrinogen (FIB) to severity of coronary lesions in patients with coronary artery disease (CAD). Methods: A total of 324 patients with angiography (CAG) conifrmed diagnosis were divided into 2 sets of groups.①By CAG examination, the patients were divided into 2 groups: CAD group,n=262 and Non-CAD group,n=62.②By Gensini scoring system, the patients were divided into 4 quartile groups: 1st quartile group,n=58, 2nd quartile group,n=110, 3rd group, n=80 and 4th quartile group,n=76. The blood levels of total bilirubin (TBIL), total cholesterol (TC), LDL-C, HDL-C, TG and ifbrinogen were measured and bilirubin blood lipid comprehensive index, TC/(HDL-C+TBIL) and LDL-C/(HDL-C+TBIL) were calculated respectively. Results:①By CAG examination, compared with Non-CAD group, CAD group had increased TC, LDL-C, ratios of TC/(HDL-C+TBIL), LDL-C/(HDL-C+TBIL) and FIB,P Conclusion: Bilirubin blood lipid comprehensive index and ifbrinogen were positively related to severity of coronary lesions in CAD patients.
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Objective To select health individual and test serum total bilirubin and direct bilimbin in order to provide a reference range for the establishment of appropriate reference interval in this region.Methods From October to December in 2009,314 of physical examination population of Beijing Hospital were selected by questionnaire and laboratory test excluding liver and gallbladder diseases or metabolic diseases.Roche and Prodia reagents were used to test TBIL and DBIL,respectively.Reference interval was calculated by sex group and compared with the existing reference interval.Results The level of TBIL had a significant difference between different genders(P ＜ 0.01).The level of TBIL had a significant difference between two kinds of reagents(P ＜ 0.01).Using Roche reagent,the reference interval of TBIL was 7.1 ～ 27.2 μmol/L for man,and 4.8 ～ 20.9 μmol/L for woman,and the reference interval of DBIL was 1.4 ～6.8 μmol/L for man,and 0.9 ～5.7 μmol/L for woman.Using Prodia reagent,the reference interval of TBIL was 9.5 ～ 35.7 μmol/L for man,and 6.8 ～ 28.9 μmol/L for woman,and the reference interval of DBIL was 1.3 ～ 7.0 μmol/L for man,and 1.0 ～ 6.6 μmol/L for woman.Conclusions The level of TBIL and DBIL in physical examination population was higher than the existing reference interval.It is necessary to modify the existing reference interval and establish reasonable reference interval for different regions and gender,respectively.