First off, here is another study (actually a meta-analysis of other studies) showing that incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ased
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin is related
to decre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ased risk of atherosclerosis.
http://www.ebmonline...tract/228/5/568...
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Inverse Relationship Between Serum ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>Bilirubin and Atherosclerosis in Men: A Meta-Analysis of Published Studies ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Ladislav Novotnass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc_img' src='http://www.ebmonline.org/math/yacute.gif' alt='Posted Image' />ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>* and Libor Vítekass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc_img' src='http://www.ebmonline.org/math/dagger.gif' alt='Posted Image' />ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>,1 ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>* EuroMISE Center-Cardio and Institute of Hygienic Medicine and Epidemiology, and
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc_img' src='http://www.ebmonline.org/math/dagger.gif' alt='Posted Image' /> 4th Department of Internal Medicine and Institute of Clinical Biochemistry and Labora
tory Diagnostics, 1st Medical Faculty, Charles University, Prague, Czech Republic
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Abstract
Bilirubin, a major intrav
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ascular product of heme catabolism,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> is a
potent antioxidant compound. Numerous studies have been
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> published showing the
relationship between serum
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin levels
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> and atherosclerosis. In the present investigation all the epidemiological
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> studies available on the effect of serum
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin levels and
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> atherosclerotic dise
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase were analyzed. Studies on the epidemiology
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> of atherosclerotic dise
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ases in
relation to serum
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin levels
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> were searched in the MEDLINE datab
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase. Selected studies were
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> subdivided according
to serum
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin levels and severity
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> of atherosclerotic dise
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase. Because of the limited number of
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> females involved in the studies, only males were included into
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> meta-analysis.
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>Associations for ordered categorical variables
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> (
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin and natural his
tory of graded atherosclerosis) were
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> ass='searchlite'>ass='searchlite'>ass='searchlite'>assessed
to find cor
relation and linear trend between analyzed
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> variables. A stratified analysis w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as conducted
to compare risks
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> of clinical outcomes. Eleven relevant studies were used for
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> analysis. A close negative
relationship w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as found between serum
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> bilirubin levels and severity of atherosclerosis (Spearman rank
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> coefficient
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>r = -0.31,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>P < 0.0001). The linear trend w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as confirmed
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> in analysis of proportions with x
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>2 values for both dise
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase conditions
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> to be very significant (
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>P < 0.0001). Unambiguous inverse
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> relationship between serum
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin levels and atherosclerosis
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as demonstrated in this preliminary meta-analytic study. These
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> results indicate the importance of hem oxygen
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase-related products
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> in the prevention of oxidative stress-mediated dise
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ases.
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'> ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Key Words: atherosclerosis • oxidative stress • ischemia • artery dise
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase
...
To be fair, there are still questions about whether it is the incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ased
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin or the incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ased heme oxygen
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase (the enzyme that breaks down the red blood cells
to start the process that produces
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin eventually) that is responsible for reduced atherosclerosis. Now those with Gilbert's Syndrome, depending on their specific mutation, may have both a decre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase in
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin conjugation
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as well
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as an incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase in
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin production (through extra heme oxygen
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase activity). This is documented in the following study.
<A href="
http://www.ncbi.nlm....pubmed/11915038...
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Hemolysis and ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin conjugation in ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>association with UDP-glucuronosyltransferass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase 1A1 promoter polymorphism.ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Kaplan M,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Hammerman C,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Rubaltelli FF,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Vilei MT,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Levy-Lahad E,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Renbaum P,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Vreman HJ,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Stevenson DK,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>Muraca M.Department of Neona
tology, Clinical Genetics Service, Shaare Zedek Medical Center, Faculty of Medicine of the Hebrew University, Jerusalem, Israel. kaplan@cc.huji.ac.il
Hemolysis may contribute
to hyper
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubinemia in Gilbert's syndrome. The authors examined blood carboxyhemoglobin corrected for inspired CO (COHbc)
to index heme catabolism and serum conjugated
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin fractions
to reflect
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin conjugation. Both parameters were related
to UDP-glucuronosyltransfer
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase 1A1 (UGT) promoter polymorphism,
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>associated with Gilbert's syndrome, in term male newborns. COHbc w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as expressed
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as percentage of
total hemoglobin, and
total conjugated
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin (TCB) value
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as a percentage of serum
total
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin (STB), (TCB/STB[%]). A production/conjugation index, COHbc/(TCB/STB[%]), represented
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin production divided by conjugation. UGT promoter genotype w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as designated according
to the number of promoter TA insertions in each allele: 6/6, homozygous normal; 6/7, heterozygous; 7/7, homozygous variant. STB and COHbc values were higher in the 7/7 subgroup than the other counterparts (P <.01). The COHbc/(TCB/STB[%]) w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as higher in the 7/7 than either the 6/6 or 6/7 subsets (1.93 [1.31-2.88] vs. 0.85 [0.51-1.72] and 0.84 [0.53-1.87], respectively; P <.01). In conclusion, 7/7 UGT promoter polymorphism w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>associated with incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ased blood COHbc values (unexpected finding)
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as well
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as diminished serum
total conjugated
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubin ratios (expected finding). The incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ased hemolysis may contribute
to the pathogenesis of incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ased STB values seen in Gilbert's syndrome, and exacerbate neonatal hyper
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>bilirubinemia
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>associated with the promoter polymorphism.
...
I recently had an EBCT (electron beam computed
tomography) scan done
to ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>assess my atherosclerosis level. I just got the results and they rate me with a score of zero. From this page on
identifying ass='searchlite'>ass='searchlite'>ass='searchlite'>asymptomatic coronary artery diseass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase, we get the following information on what the scores mean.
...
<H3 cl
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass=dynamic>How Do I Interpret My Coronary Calcium Score?</H3>
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>- 0 - No plaque is present. There is less than a 5% chance of having heart diseass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase. Risk of a heart attack is very low.
- 1 – 10 - A small amount of plaque is present. There is less than a 10% chance of having heart diseass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase. Risk of a heart attack is low.
- 11 – 100 - Plaque is present. There is mild heart diseass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase. The chance of a heart attack is moderate.
- 101 – 400 - A moderate amount of plaque is present. There is heart diseass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase; plaque may be blocking an artery. The chance of a heart attack is moderate to high. Your health professional may want to do more tests and may start treatment for heart diseass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase. Aggressive treatment may be started for risk factors such ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as high blood pressure and high cholesterol.
- Over 400 - A large amount of plaque is present. There is more than a 90% chance that plaque is blocking one of the arteries. The chance of a heart attack is high. Your health professional will want to do more tests and will start treatment.
<H3 cl
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass=dynamic>What Are The Risks Of Having A Heart Scan?</H3>
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>- Critics raise the issue of false negative results in heart scanning especially in younger populations. A negative result may not detect soft plaques.
- Although calculated risk is present, actual risk (of course) cannot and is not and must be ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>assumed ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as such. Critics note that further invass='searchlite'>asive tests may be performed (cardiac catherization and/or angioplass='searchlite'>asty).
- CT scanning increass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ases radiation exposure comparable to multiple chest x-rays.
<H3 cl
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass=dynamic>What Are The Benef
its?</H3>
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='bbc'>- Knowing your risk.
- Dependent on the results, identifying the risk of cardiac event in the immediate future spurs lifestyle changes and fosters a proactive approach by both the patient and the physician towards targeted medical prevention and/or timely intervention.
...
Now, one of the re
asons I had the test done (probably the main re
ason) is that my father h
as been
told that he h
as higher than expected atherosclerosis, given his level of cholesterol (which isn't low, but isn't extremely high either). I wanted
to see if I w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as genetically predisposed
to atherosclerosis. I theorized that if I w
as, I might show some level of build-up, even though I'm only 37 years old.
As the test shows, I have no plaque present (that can be detected with this test -- might still have non-calcium plaques). However, according
to the information I w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as given with the results, it h
as statistics showing that 80% of people my age have a score of zero.
Personal analsysis:
1) I could have the same issue that my father h
as, but my Gilbert's Syndrome is countering it, thus I have no atherosclerosis.
2) I could have the same issue that my father h
as, but the issue may not show build up at my age, even if I didn't have Gilbert's Syndrome.
3) I could not have the same issue that my father h
as and even without Gilbert's Syndrome, I'd have an 80% chance of having a score of zero.
4) I could not have the same issue that my father h
as, and the Gilbert's Syndrome is helping me stay within the 80% percentile.
In other words, this test really says nothing conclusively about my personal
relationship between Gilbert's Syndrome and atherosclerosis. It does provide peace of mind that I don't show calcification of my arteries at this point in my life. The other re
ason I may have had some concerns is that my HDL cholesterol levels are lower than I'd like (35 and 32 mg/dL in my l
ass='searchlite'>ast two tests in the l
ass='searchlite'>ast 4 months, which is lower than the bot
tom end of "normal", with normal being 40-50 mg/dL).
I should also add that my self
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>assessment that I gave
to the technicians w
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as a rating of 2/10 on how much I exercise and 5/10 on how low fat my diet is. In other words, very little exercise and middle of the road fat content. I do plan on incre
asing my exercise when I'm done with some other personal tests regarding resveratrol mi
tochondrial biogenesis
potential that exercise may confound.
My current plan is
to have this test done once every 5 years. By keeping an eye on this, I hope
to get an early handle on atherosclerosis if it does begin
to rise. It is normal for it
to rise
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>as you age, but I'd much rather be abnormal in this regard,
to incre
ass='searchlite'>ass='searchlite'>ass='searchlite'>ass='searchlite'>ase my chances of longevity.
If anyone reading this who h
as Gilbert's Syndrome and who is older h
as this test done, I'd be very interested in the results.
David