Serum bilirubin and 10-year mortality risk in a Belgian population
Cite this article as: Temme, E.H., Zhang, J., Schouten, E.G. et al. Cancer Causes Control (2001) 12: 887. doi:10.1023/A:1013794407325 Abstract objective: The endogenous antioxidant serum bilirubin may scavenge free radicals and protect against free radical-related diseases. Methods: Using the 10-year follow-up mortality data from the Belgium Inter-university Research on Nutrition and Health (BIRNH) study the association between serum bilirubin and all-cause, cardiovascular, and cancer mortality in 5460 men and 4843 women was investigated. Results: In men, with the highest (≥0.6 mg/dl) compared with the lowest serum bilirubin concentration (≤0.2 mg/dl), the adjusted relative risk (RR) was 0.73 (95% confidence interval (CI) 0.57–0.94) for all-cause and 0.42 (95% CI 0.26–0.68) for cancer mortality. The risk for cancer mortality decreased with increasing concentrations of serum bilirubin ( p for trend = 0.004) especially for non-lung cancer mortality ( p for trend = 0.02). The associations persisted after adjusting for smoking. In women the associations between serum bilirubin and cancer mortality were in the same direction, but did not reach statistical significance (RR = 0.76, 95% CI 0.39–1.5). No significant associations were found between serum bilirubin and cardiovascular mortality in men and women. Conclusions: In this population high serum bilirubin, however, within normal ranges, was associated with low cancer mortality, especially in men. This may be due to the antioxidant activity of bilirubin. Measurement of serum bilirubin concentrations may contribute to cancer risk estimation. bilirubin cancer cardiovascular healthy subjects mortality prospective study. References
Davies KJA (1995) Oxidative stress: the paradox of aerobic life.
Biochem Soc Symp
Frei B (1994) Reactive oxygen species and antioxidant vitamins: mechanisms of action.
Am J Med
(Suppl. 3A): 5S-13S.
Halliwell B (1991) Reactive oxygen species in living systems: source, biochemistry and role in human disease.
Am J Med
(Suppl. 3C): 14S-22S.
Stocker R, Yamamoto Y, McDonagh AF, Glazer AN, Ames BN (1987) Bilirubin is an antioxidant of possible physiological importance.
Neuzil J, Stocker R (1993) Bilirubin attenuates radical-mediated damage to serum albumin.
Wu TW, Wu J, Li RK, Mickle D, Carey D (1991) Albumin-bound bilirubins protect human ventricular myocytes against oxyradical damage.
Biochem Cell Biol
Ewing JF, Haber SN, Maines MD (1992) Normal and heatinduced patterns of expression of heme oxygenase-1 (HSP32) in rat brain: hyperthermia causes rapid induction of mRNA and protein.
Hopkins PN, Wu LL, Hunt SC, James BC, Vincent GM, Williams RR (1996) Higher serum bilirubin is associated with decreased risk-for early familial coronary artery disease.
Arterioscler Thromb Vasc Biol
Schwertner HA, Jackson WG, Tolan G (1994) Association of low serum concentration of bilirubin with increased risk of coronary artery disease.
Schwertner HA (1998) Association of smoking and low serum bilirubin antioxidant concentrations.
De Backer G (1984) Regional differences in dietary habits, coronary risk factors and mortality rates in Belgium. I. Design and methodology.
Gambino SR, Freda VJ (1966) The measurement of amniotic fluid bilirubin by the method of Jendrassik and Grof.
Am J Clin Pathol
Bachorik PS, Wood PD, Albers JJ,
(1976) Plasma highdensity lipoprotein cholesterol concentrations determined after removal of other lipoproteins by heparin-manganese precipitation or by ultracentrifugation.
Kornitzer M, Dramaix M (1989) The Belgian interuniversity Research on Nutrition and Health (the BIRNH study).
Chan-Yeung M, Ferreira P, Frohlich J, Schulzer M, Tan F (1981) The effect of age, smoking, and alcohol on routine laboratory tests.
Am J Clin Pathol
Frei B, Forte TM, Ames BN, Cross CE (1991) Gas phase oxidants of eigarette smoke induce lipid peroxidation and changes in lipoprotein properties in human blood plasma.
Yamaguchi T, Shioji I, Sugimoto A, Komoda Y, Nakajima H (1994) Chemical structure of a new family of bile pigments from human urine.
Yamaguchi T, Horio F, Hashizume T,
(1995) Bilirubin is oxidized in rats treated with endotoxin and acts as a physiological antioxidant synergistically with ascorbic acid
Biochem Biophys Res Commun
Stocker R, Glazer AN, Ames BN (1987) Antioxidant activity of albumin-bound bilirubin.
Proc Natl Acad Sci
Vreman HJ, Wong RJ, Sanesi CA, Dennery PA, Stevenson DK (1998) Simultaneous production of carbon monoxide and thiobarbituric acid reactive substances in rat tissue preparations by an iron-ascorbate system.
Can J Physiol Pharmacol
Winkel P, Statland BE, Bokelund H (1974) Factors contributing to intra-individual variation of serum constituents: 5. Short-term day-to-day and within-hour variation of serum constituents in healthy subjects.
Galbraith R (1999) Heme oxygenase: who needs it.
Proc Soc Exp Biol Med
Stocker R, McDonagh AF, Glazer AN, Ames B (1990) Antioxidant activities of bile pigments: biliverdin and bilirubin.
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