Relation between unconjugated bilirubin and RDW, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio in Gilbert's syndrome.

Hakan Sarlak,Mustafa Tanriseven,Mustafa Cakar,Salim Ozenc,Erol Arslan,Fatih Bulucu,Muharrem Akhan

doi:10.1186/s40064-016-3085-5

Hakan Sarlak, Mustafa Tanriseven + Show 5 more

Open Access

https://doi.org/10.1186/s40064-016-3085-5

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Journal: SpringerPlus	Publication Date: Aug 22, 2016
Citations: 4	License type: CC BY 4.0

Affiliation: Turkish Armed Forces, Diyarbakır Askeri Hastanesi

Abstract

BackgroundUnconjugated bilirubin (UCB) plays a protective role in coronary artery disease. Red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are inflammatory biomarkers and higher levels are related to atherosclerosis and adverse cardiovascular events.AimWe aimed to investigate the relation between UCB levels and RDW, NLR, PLR in people with Gilbert’s syndrome (GS). Materials and methodsWe selected 2166 subjects (1082 with GS and 1084 healthy controls) from a database having 33,695 people. RDW, NLR and PLR were investigated in the subjects with GS and compared with the healthy controls. Linear regression analysis was used to evaluate the relation between variables.ResultsNLR and PLR were higher in the subjects with GS compared to the controls (p < 0.001). RDW was similar in both groups (p = 0.318). UCB was negatively correlated with lymphocyte counts (p = 0.040), and positively correlated with RDW (p < 0.001) and PLR (p = 0.037) in the subjects with GS. There was no significant correlation between UCB and NLR (p = 0.078). RDW (p < 0.001) and lymphocyte counts (p = 0.030) were significantly associated with UCB levels in the regression analysis conducted in the subjects with GS.ConclusionThere is a negative association between UCB and NLR, PLR due to low amounts of lymphocyte counts, which causes increased risk of CVD. These results suggest that the cardio-protective effect of UCB is due to both anti-oxidative and anti-inflammatory ways indirectly.

Highlights

Unconjugated bilirubin (UCB) plays a protective role in coronary artery disease
There is a negative association between UCB and neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) due to low amounts of lymphocyte counts, which causes increased risk of CVD
These results suggest that the cardio-protective effect of UCB is due to both antioxidative and anti-inflammatory ways indirectly

Summary

Introduction

Unconjugated bilirubin (UCB) plays a protective role in coronary artery disease. Red cell distribution width (RDW), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are inflammatory biomarkers and higher levels are related to atherosclerosis and adverse cardiovascular events. Gilbert’s syndrome is an inborn disorder of bilirubin glucuronidation, characterized by recurrent episodes of jaundice and may be triggered by some conditions such as; dehydration, fasting, menstruation, heavy exercise and other accompanying diseases. UCB plays a protective role in diseases related with oxidative stress as an antioxidant in low concentrations (20–100 μM) (between 1.17 and 5.85 mg/dL) (Schwertner and Vítek 2008). It has been shown that unconjugated hyperbilirubinemia is associated with decreased risk of coronary and carotid stenosis, peripheral atherosclerosis, ischaemic heart disease, vascular complications in diabetics and even cancer (Vítek et al 2002; Hjelkrem et al 2012).

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