Serum Total Bilirubin Level, Prevalent Stroke, and Stroke Outcomes: NHANES 1999–2004 - 20/08/11
, Reena L. Pande, MD a, Mark A. Creager, MD a, Jennifer Weuve, ScD b, Joshua A. Beckman, MD a
Requests for reprints should be addressed to Todd S. Perlstein, MD, Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, A322, Boston, MA 02115Abstract |
Background |
Bilirubin inhibits experimental atherosclerosis, is inversely associated with carotid plaque burden, and confers neuroprotection in experimental stroke. Clinical data addressing the association of bilirubin with stroke are not available. We hypothesized that higher bilirubin levels would be associated with reduced stroke prevalence and improved stroke outcomes.
Methods |
We used the National Health and Nutrition Examination Survey 1999 to 2004, a nationally representative cross-sectional examination of the United States civilian population, to examine the association of bilirubin with stroke. Of 13,214 adult participants with data on stroke history, serum total bilirubin level, and stroke risk factors, 453 reported a history of stroke. Of these, 138 participants reported an adverse stroke outcome, defined as a long-term health problem or disability due to stroke. We performed multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) with adjustment for demographic characteristics and stroke risk factors.
Results |
After multivariable adjustment, a 1.71 μmol/L (0.1 mg/dL) increment in bilirubin level was associated with a 9% reduced odds of stroke (OR 0.91; 95% CI, 0.86-0.96) among all participants and with a 10% reduced odds of an adverse stroke outcome (OR 0.90; 95% CI, 0.80-1.00) among participants with a history of stroke.
Conclusions |
These results suggest that a higher serum total bilirubin level is associated with reduced stroke prevalence and improved stroke outcomes. Our findings support the hypothesis that bilirubin may protect from stroke events and from neurologic damage in stroke.
Le texte complet de cet article est disponible en PDF.Keywords : Bilirubin, Epidemiology, Heme oxygenase, National Health and Nutrition Examination Survey, Nutrition survey, Stroke
Plan
| Dr Perlstein was supported by the National Heart, Lung and Blood Institute (NHLBI) Training Grant T32 HL07604 and an American College of Cardiology Foundation/Merck Research Fellowship Award. Dr Beckman was supported by American Diabetes Association Career Development Award 1-06-CD-01. Dr Creager is the Simon C. Fireman Scholar in Cardiovascular Medicine. Dr Pande was supported by NHLBI training grant T32 HL07604 and by a Research Career Development Award (K12 HL083786) from the NHLBI. Dr Weuve is partially supported by National Institutes of Environmental Health Sciences R01ES005257. This work also was supported by NHLBI grant R01 HL075771. |
Vol 121 - N° 9
P. 781 - septembre 2008 Retour au numéro
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