Abstract
BackgroundHigh serum bilirubin levels have been shown to be associated with an improved pulmonary function test results. Their potential ability to similarly benefit pulmonary function in an environment of polluted air has not been tested. We retrospectively analyzed data of 15,605 apparently healthy individuals in order to evaluate the effect of serum bilirubin levels on forced expiratory volume in 1 s (FEV1).MethodsIndividuals attended the Tel-Aviv Medical Center Inflammatory Survey for a routine annual health check between February, 2002 and June, 2009 and were divided into low, medium and high serum bilirubin levels. Their FEV1 results were compared under various levels of air pollution. Air pollution and weather data were obtained from air pollution monitoring stations of the Israeli Ministry of Environmental Protection.ResultsThe elevated serum bilirubin concentrations on FEV1 were evaluated under moderate and high pollution levels FEV1 and were significantly higher in participants with high blood bilirubin levels compared to medium or low levels (p < 0.001 and p = 0.018, respectively). Participants with high levels of bilirubin had preserved FEV1 under exposure to high and medium pollution levels of both Nitrogen Oxide (NOx) and Carbon Monoxide (CO) pollutants (p = 0.003 and p = 0.022, respectively). The multivariate regression analysis revealed that the influence of bilirubin under conditions of air pollution remained significant even after adjustment for FEV1 confounders, but the interaction was not significant.ConclusionsElevated serum bilirubin concentrations are associated with preserved lung function in healthy individuals in Israel exposed to high levels of air pollution.
Highlights
High serum bilirubin levels have been shown to be associated with an improved pulmonary function test results
In a Swiss study on Air Pollution and Lung Disease in adults (SAPALDIA), increased concentrations of serum bilirubin were associated with improved parameters of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) ratio (FEV1/FVC) and forced expiratory flow at 25–75% of FVC (FEF25–75%), after adjusting for the effects of sex, age, education, height, and weight and tobacco smoke exposure [10]
Current smokers had lower FEV1 and FEV1/FVC values compared to past smokers and
Summary
High serum bilirubin levels have been shown to be associated with an improved pulmonary function test results. Their potential ability to benefit pulmonary function in an environment of polluted air has not been tested. In a Swiss study on Air Pollution and Lung Disease in adults (SAPALDIA), increased concentrations of serum bilirubin were associated with improved parameters of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) ratio (FEV1/FVC) and forced expiratory flow at 25–75% of FVC (FEF25–75%), after adjusting for the effects of sex, age, education, height, and weight and tobacco smoke exposure [10]. Another study showed inverse association between total bilirubin level and CVD risk, independent of other risk factors [12]. Bilirubin concentrations were negatively associated with the history, duration, and intensity of smoking, suggesting a possible role of inhaled tobacco in the pathogenesis of lung function deterioration related to oxidative stress [14]
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