Gilbert’s syndrome: protective effect on endothelial dysfunction

Abstract

Abstract Objective Gilbert’s syndrome (GS), is a benign condition characterized by unconjugated hyperbilirubinemia related to a decreased hepatic glucuronidating activity without symptoms and signs of liver disease or overt hemolysis. In the present study, we aimed to assess circulating levels of asymmetric dimethylarginine (ADMA), pentraxin-3 (PTX-3) and high sensitivity C-reactive protein (hs-CRP) between patients with GS and controls and determine the correlation of unconjugated bilirubin (UCB) levels with these molecules as prognostic factors for vascular risk stratification and endothelial dysfunction. Methods Forty two patients with GS and 37 age and sex matched control subjects were enrolled in this study. The diagnosis of GS was made by unconjugated hyperbilirubinemia (1 mg/dL or >17.1 μmol/L) on at least two occasions with normal values of other liver function tests, normal hepatic imaging, and absence of hemolysis. Results Serum ADMA, PTX-3 and hs-CRP levels were significantly lower in GS than the healthy controls (p=0.037, p=0.025 and p=0.040, respectively). In correlation analysis, UCB was negatively correlated with ADMA, PTX-3 and hs-CRP (r=−0.239, p=0.034; r=−0.280, p=0.012 and r=−0.224, p=0.047, respectively). Discussion and conclusion The present study showed for the first time that decreased levels of ADMA, PTX-3 and hs-CRP may prove the protective effects of hyperbilirubinemia on the endothelial dysfunction.