Ang-Tse Lee1, Ya-Yu Wang2, Shih-Yi Lin3, Jiin-Tsae Liang4, Wayne Huey-Herng Sheu5, Yuh-Min Song1, Wen-Dau Chang6. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital Taichung, Taiwan. 2. Department of Family Medicine, Taichung Veterans General HospitalTaichung, Taiwan; Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing UniversityTaichung, Taiwan; School of Medicine, National Yang Ming UniversityTaipei, Taiwan. 3. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General HospitalTaichung, Taiwan; School of Medicine, National Yang Ming UniversityTaipei, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General HospitalTaichung, Taiwan. 4. Division of Biochemistry, Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital Taichung, Taiwan. 5. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General HospitalTaichung, Taiwan; School of Medicine, National Yang Ming UniversityTaipei, Taiwan; School of Medicine, National Defense Medical CenterTaipei, Taiwan. 6. Department of Family Medicine, Taichung Veterans General Hospital Taichung, Taiwan.
Abstract
BACKGROUND: Chronic inflammation is proposed to play a central role in the pathogenesis of chronic kidney disease (CKD), and serum bilirubin has antioxidant and anti-inflammatory effects. We investigated the association between serum total bilirubin (Tb) concentration and renal function in an adult population. METHODS: We conducted a cross-sectional study and collected anthropometric measurements, fasting blood tests, lifestyle habits and medical history of 3876 subjects attending a health examination. Renal insufficiency was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) calculated by using the CKD-EPI equation. RESULTS: Serum Tb concentrations were higher in subjects without renal insufficiency than in those with renal insufficiency. Multivariable linear regression analysis showed that Tb concentration was positively associated with eGFR after adjusting for important CKD risk factors (P=0.04). Multivariable logistic regression analysis also revealed that higher Tb concentration (each increment of 1.71 μmol/L) (0.1 mg/dL) was associated with a reduced risk of renal insufficiency: odds ratios were 0.94 (P=0.005) for men and 0.90 (P=0.015) for women, respectively. When subjects were divided into quartiles of serum Tb, multivariable-adjusted odds ratios for renal insufficiency comparing the fourth to the first Tb quartile were 0.49 (P=0.001) for men and 0.35 (P=0.003) for women. A stepwise exclusion of subjects, first those with possible liver disease and second, those with CKD stage 4 and 5, showed consistent results. CONCLUSION: Higher serum Tb concentration was associated with lower risk of renal insufficiency, regardless of other conventional CKD risk factors.
BACKGROUND:Chronic inflammation is proposed to play a central role in the pathogenesis of chronic kidney disease (CKD), and serum bilirubin has antioxidant and anti-inflammatory effects. We investigated the association between serum total bilirubin (Tb) concentration and renal function in an adult population. METHODS: We conducted a cross-sectional study and collected anthropometric measurements, fasting blood tests, lifestyle habits and medical history of 3876 subjects attending a health examination. Renal insufficiency was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m(2) calculated by using the CKD-EPI equation. RESULTS: Serum Tb concentrations were higher in subjects without renal insufficiency than in those with renal insufficiency. Multivariable linear regression analysis showed that Tb concentration was positively associated with eGFR after adjusting for important CKD risk factors (P=0.04). Multivariable logistic regression analysis also revealed that higher Tb concentration (each increment of 1.71 μmol/L) (0.1 mg/dL) was associated with a reduced risk of renal insufficiency: odds ratios were 0.94 (P=0.005) for men and 0.90 (P=0.015) for women, respectively. When subjects were divided into quartiles of serum Tb, multivariable-adjusted odds ratios for renal insufficiency comparing the fourth to the first Tb quartile were 0.49 (P=0.001) for men and 0.35 (P=0.003) for women. A stepwise exclusion of subjects, first those with possible liver disease and second, those with CKD stage 4 and 5, showed consistent results. CONCLUSION: Higher serum Tb concentration was associated with lower risk of renal insufficiency, regardless of other conventional CKD risk factors.
Entities:
Keywords:
Bilirubin; cardiovascular disease; chronic kidney disease; kidney function
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