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Article: Association of lower total bilirubin level with statin usage: the United States National Health and Nutrition Examination Survey 1999–2008

TitleAssociation of lower total bilirubin level with statin usage: the United States National Health and Nutrition Examination Survey 1999–2008
Authors
Issue Date2011
PublisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/atherosclerosis
Citation
Atherosclerosis, 2011, v. 219 n. 2, p. 728-733 How to Cite?
AbstractOBJECTIVE: A low circulating level of bilirubin is associated with increased cardiovascular risk. As statins can stimulate heme oxygenase-1 (HO-1), which increases bilirubin production, we investigated whether statins in routine use increase total bilirubin levels in subjects at high cardiovascular risk. METHODS: Data from 3290 subjects with self-reported history of hypercholesterolemia, diabetes, or cardiovascular diseases in the United States National Health and Nutrition Examination Survey (NHANES) 1999-2008 were analyzed. RESULTS: Subjects taking statins (n = 1156) had lower total bilirubin levels than those not taking any lipid-lowering medication (n = 2134) after adjusting for age, sex, race/ethnicity, and survey period (adjusted mean = 0.699 vs 0.729 mg/dl respectively, P=0.001). The association remained significant after adjusting for more covariates (P = 0.002), but was attenuated after further adjusting for glycosylated hemoglobin, insulin resistance index, and low-density lipoprotein (LDL) cholesterol (P = 0.043). The use of lovastatin, rosuvastatin, and cerivastatin was associated with lower total bilirubin levels in the full adjustment model (P < 0.05). CONCLUSION: The use of statins was associated unexpectedly with lower total bilirubin levels. This could be explained at least partly by the effect of statins on glycemia and LDL cholesterol. Our results do not suggest that the anti-oxidant and anti-inflammatory effects of statins are due to HO-1 induction and increased serum bilirubin levels.
Persistent Identifierhttp://hdl.handle.net/10722/163429
ISSN
2015 Impact Factor: 3.942
2015 SCImago Journal Rankings: 1.819
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorOng, KLen_US
dc.contributor.authorWu, BJen_US
dc.contributor.authorCheung, BMYen_US
dc.contributor.authorBarter, PJen_US
dc.contributor.authorRye, KAen_US
dc.date.accessioned2012-09-05T05:31:16Z-
dc.date.available2012-09-05T05:31:16Z-
dc.date.issued2011en_US
dc.identifier.citationAtherosclerosis, 2011, v. 219 n. 2, p. 728-733en_US
dc.identifier.issn0021-9150en_US
dc.identifier.urihttp://hdl.handle.net/10722/163429-
dc.description.abstractOBJECTIVE: A low circulating level of bilirubin is associated with increased cardiovascular risk. As statins can stimulate heme oxygenase-1 (HO-1), which increases bilirubin production, we investigated whether statins in routine use increase total bilirubin levels in subjects at high cardiovascular risk. METHODS: Data from 3290 subjects with self-reported history of hypercholesterolemia, diabetes, or cardiovascular diseases in the United States National Health and Nutrition Examination Survey (NHANES) 1999-2008 were analyzed. RESULTS: Subjects taking statins (n = 1156) had lower total bilirubin levels than those not taking any lipid-lowering medication (n = 2134) after adjusting for age, sex, race/ethnicity, and survey period (adjusted mean = 0.699 vs 0.729 mg/dl respectively, P=0.001). The association remained significant after adjusting for more covariates (P = 0.002), but was attenuated after further adjusting for glycosylated hemoglobin, insulin resistance index, and low-density lipoprotein (LDL) cholesterol (P = 0.043). The use of lovastatin, rosuvastatin, and cerivastatin was associated with lower total bilirubin levels in the full adjustment model (P < 0.05). CONCLUSION: The use of statins was associated unexpectedly with lower total bilirubin levels. This could be explained at least partly by the effect of statins on glycemia and LDL cholesterol. Our results do not suggest that the anti-oxidant and anti-inflammatory effects of statins are due to HO-1 induction and increased serum bilirubin levels.en_US
dc.languageengen_US
dc.publisherElsevier Ireland Ltd. The Journal's web site is located at http://www.elsevier.com/locate/atherosclerosisen_US
dc.relation.ispartofAtherosclerosisen_US
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in Atherosclerosis. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Atherosclerosis, 2011, v. 219 n. 2, p. 728-733. DOI: 10.1016/j.atherosclerosis.2011.07.094-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshBilirubin - blooden_US
dc.subject.meshDrug Utilization Reviewen_US
dc.subject.meshDyslipidemias - blood - drug therapy - ethnologyen_US
dc.subject.meshHeme Oxygenase-1 - metabolismen_US
dc.subject.meshHydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic useen_US
dc.titleAssociation of lower total bilirubin level with statin usage: the United States National Health and Nutrition Examination Survey 1999–2008en_US
dc.typeArticleen_US
dc.identifier.emailOng, KL: okl2000@hku.hken_US
dc.identifier.emailCheung, BMY: mycheung@hku.hk-
dc.identifier.authorityCheung, BMY=rp01321en_US
dc.description.naturepostprinten_US
dc.identifier.doi10.1016/j.atherosclerosis.2011.07.094en_US
dc.identifier.pmid21840000-
dc.identifier.scopuseid_2-s2.0-82955187697en_US
dc.identifier.hkuros204109-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-82955187697&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume219en_US
dc.identifier.issue2en_US
dc.identifier.spage728en_US
dc.identifier.epage733en_US
dc.identifier.isiWOS:000298813900058-
dc.publisher.placeIrelanden_US
dc.identifier.scopusauthoridRye, KA=7006700031en_US
dc.identifier.scopusauthoridBarter, PJ=7005927655en_US
dc.identifier.scopusauthoridCheung, BMY=7103294806en_US
dc.identifier.scopusauthoridWu, BJ=36991007900en_US
dc.identifier.scopusauthoridOng, KL=8340854000en_US

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