PMID- 24209691
OWN - NLM
STAT- MEDLINE
DCOM- 20140902
LR  - 20220310
IS  - 1475-2840 (Electronic)
IS  - 1475-2840 (Linking)
VI  - 12
DP  - 2013 Nov 9
TI  - High sensitive C-reactive protein and serum amyloid A are inversely related to 
      serum bilirubin: effect-modification by metabolic syndrome.
PG  - 166
LID - 10.1186/1475-2840-12-166 [doi]
AB  - BACKGROUND: Bilirubin has been implicated in cardiovascular protection by virtue 
      of its anti-inflammatory and anti-oxidative properties. The metabolic syndrome is 
      featured by enhanced low-grade systemic inflammation and oxidative stress. Serum 
      amyloid A (SAA) impairs anti-oxidative properties of high-density lipoprotein 
      (HDL). We determined relationships of high sensitive C-reactive protein (hs-CRP) 
      and SAA with bilirubin in subjects with and without metabolic syndrome (MetS). 
      METHODS: Serum total bilirubin, hs-CRP, SAA and homeostasis model assessment- 
      insulin resistance (HOMA-IR) were documented in 94 subjects with and in 73 
      subjects without MetS (26 and 54 subjects with type 2 diabetes mellitus (T2DM), 
      respectively). RESULTS: Bilirubin was lower in MetS (P = 0.013), coinciding with 
      higher hs-CRP (P < 0.001) and SAA levels (P = 0.002). In all subjects combined, 
      hs-CRP was inversely related to bilirubin (r = -0.203, P = 0.008), irrespective 
      of the presence of MetS or T2DM (interaction terms: P >/= 0.75). The inverse 
      relationship of bilirubin with SAA was confined to subjects without MetS 
      (r = -0.267, P = 0.009). Furthermore, the presence of either MetS or T2DM 
      modified the relationship of bilirubin with SAA (interaction terms: beta = 0.366, 
      P = 0.003 and beta = 0.289, P = 0.025, respectively) in age- and sex-adjusted 
      analyses. Effect modification was also found for HOMA-IR (beta = 0.790, P = 0.020). 
      Of the individual MetS components, the strongest interaction of bilirubin on SAA 
      was observed with low HDL cholesterol (beta = 0.435, P < 0.001). CONCLUSIONS: hs-CRP 
      is inversely related to bilirubin, suggesting that low bilirubin is implicated in 
      enhanced low-grade systemic inflammation. The inverse relationship of SAA with 
      bilirubin was found to be absent in MetS, which could be attributable to 
      MetS-associated abnormalities in HDL characteristics.
FAU - Deetman, Petronella E
AU  - Deetman PE
FAU - Bakker, Stephan J L
AU  - Bakker SJ
FAU - Dullaart, Robin P F
AU  - Dullaart RP
AD  - Department of Endocrinology, University of Groningen, University Medical Center 
      Groningen, P,O, Box 30,001, Groningen 9700 RB, The Netherlands. 
      r.p.f.dullaart@umcg.nl.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131109
PL  - England
TA  - Cardiovasc Diabetol
JT  - Cardiovascular diabetology
JID - 101147637
RN  - 0 (Cholesterol, HDL)
RN  - 0 (Serum Amyloid A Protein)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - RFM9X3LJ49 (Bilirubin)
SB  - IM
MH  - Aged
MH  - Bilirubin/*blood
MH  - C-Reactive Protein/*metabolism
MH  - Case-Control Studies
MH  - Cholesterol, HDL/*metabolism
MH  - Diabetes Mellitus, Type 2/complications/*metabolism
MH  - Female
MH  - Humans
MH  - Insulin Resistance
MH  - Linear Models
MH  - Male
MH  - Metabolic Syndrome/complications/*metabolism
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Serum Amyloid A Protein/*metabolism
PMC - PMC4176750
EDAT- 2013/11/12 06:00
MHDA- 2014/09/03 06:00
PMCR- 2013/11/09
CRDT- 2013/11/12 06:00
PHST- 2013/09/20 00:00 [received]
PHST- 2013/10/28 00:00 [accepted]
PHST- 2013/11/12 06:00 [entrez]
PHST- 2013/11/12 06:00 [pubmed]
PHST- 2014/09/03 06:00 [medline]
PHST- 2013/11/09 00:00 [pmc-release]
AID - 1475-2840-12-166 [pii]
AID - 10.1186/1475-2840-12-166 [doi]
PST - epublish
SO  - Cardiovasc Diabetol. 2013 Nov 9;12:166. doi: 10.1186/1475-2840-12-166.