Abstract
Low concentrations of bilirubin are associated with an increased risk for cardiovascular disease (CVD). Possibly, bilirubin exerts its effect through the protection of LDL from oxidation. Therefore, we examined whether low bilirubin might also be a risk marker for CVD in patients with familial hypercholesterolemia (FH) and whether statins influence serum bilirubin levels. Patients with FH were recruited from 37 lipid clinics. After a washout period of 6 weeks, all patients were started on monotherapy with simvastatin 80 mg for a period of two years. A total of 514 patients were enrolled. Bilirubin at baseline was inversely associated with the presence of CVD, also after adjustment for age, gender, presence of hypertension, and HDL cholesterol levels. Moreover, bilirubin levels were significantly raised, by 7%, from 10.0 to 10.8 μmol/L after treatment with simvastatin 80 mg. We hypothesize first that high bilirubin levels might protect patients with FH from CVD. Furthermore, bilirubin levels were significantly increased after treatment with simvastatin 80 mg, independent of changes in liver enzymes, which might confer additional protection against CVD. Whether this is also true for lower doses of simvastatin or for other statins remains to be investigated.
Highlights
Low concentrations of bilirubin are associated with an increased risk for cardiovascular disease (CVD)
Data for the present analysis were derived from the database of the ExPRESS familial hypercholesterolemia (FH) (Examination of Probands and Relatives in Statin Studies with Familial Hypercholesterolemia) study, in which the two year efficacy and safety of simvastatin 80 mg were evaluated in 526 heterozygous FH patients [17]
Among the 526 FH patients who participated in the ExPRESS FH study, baseline total bilirubin levels were available for 514 patients, and these patients comprised our study population
Summary
Low concentrations of bilirubin are associated with an increased risk for cardiovascular disease (CVD). We examined whether low bilirubin might be a risk marker for CVD in patients with familial hypercholesterolemia (FH) and whether statins influence serum bilirubin levels. Bilirubin levels were significantly increased after treatment with simvastatin 80 mg, independent of changes in liver enzymes, which might confer additional protection against CVD. Serum total bilirubin concentrations have been shown to be inversely associated with the risk for cardiovascular disease (CVD) [1,2,3,4,5,6,7,8,9,10]. The underlying defect consists of mutations in the gene encoding for the LDL receptor protein or in its ligand, apo B-100 These mutations result in markedly elevated plasma cholesterol levels, predisposing FH patients to premature atherosclerosis and CVD [16].
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
