Serum total bilirubin level and prevalent lower-extremity peripheral arterial disease - National Health and Nutrition Examination Survey (NHANES) 1999 to 2004
Serum total bilirubin level and prevalent lower-extremity peripheral arterial disease - National Health and Nutrition Examination Survey (NHANES) 1999 to 2004
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DOI：
10.1161/atvbaha.107.153262
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发表时间：
2008-01-01
影响因子：
8.7
通讯作者：
Creager, Mark A.
中科院分区：
文献类型：
--
作者：
Perlstein, Todd S.;Pande, Reena L.;Creager, Mark A.
背景-胆红素，具有最近公认的抗氧化和抗氧化活性，已成为抗动脉粥样硬化的候选药物。我们假设，较高水平的胆红素会降低外周动脉疾病（PAD）的易感性。方法和结果，我们分析了7075名成年人的踝臂指数，血清总胆红素水平，PAD的危险因素，在全国健康和营养检查调查（1999年至2004年），一个全国代表性的横断面检查美国人口的数据。在校正年龄、性别、人种/种族、吸烟状况、糖尿病、高血压、高胆固醇血症、慢性肾脏疾病、CRP和同型半胱氨酸后，胆红素水平升高0.1 mg/dL与PAD几率降低6%相关（OR 0.94 [95% CI 0.90 - 0.98]）。该结果不依赖于胆红素水平高于参考范围、肝脏疾病或酒精摄入。胆红素与PAD的负相关性在男性中往往更强（OR 0.90 [95% CI 0.85 - 0.96]）与女性相比（OR 0.97 [95% CI 0.91 - 1.04]; P-相互作用=0.05），并且与非吸烟者（OR 0.97 [95% CI 0.93 - 1.02]; P-相互作用=0.05）相比，在活跃吸烟者（OR 0.81 [95% CI 0.73 - 0.90]）中更强
Background-Bilirubin, with recently recognized antioxidant and antiinflammatory activity, has emerged as a candidate for atheroprotection. We hypothesized that higher levels of bilirubin would reduce susceptibility to peripheral arterial disease (PAD).Methods and Results-We analyzed 7075 adults with data available on the ankle brachial index, serum total bilirubin level, and PAD risk factors in the National Health and Nutrition Examination Survey (1999 to 2004), a nationally representative cross-sectional examination of the United States population. A 0.1 mg/dL increase in bilirubin level was associated with a 6% reduction in the odds of PAD (OR 0.94 [95% CI 0.90 to 0.98]) after adjustment for age, gender, race/ethnicity, smoking status, diabetes, hypertension, hypercholesterolemia, chronic kidney disease, CRP, and homocysteine. This result was not dependent on bilirubin levels above the reference range, liver disease, or alcohol intake. The inverse association of bilirubin with PAD tended to be stronger among men (OR 0.90 [95% CI 0.85 to 0.96]) compared with women (OR 0.97 [95% CI 0.91 to 1.04]; P-interaction=0.05), and was stronger among active smokers (OR 0.81 [95% CI 0.73 to 0.90]) compared with nonsmokers (OR 0.97 [95% CI 0.93 to 1.02]; P-interaction