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Effects of Gilbert"s Syndrome on Lipid Profile, Levels of Serum Uric Acid, Glucose and Insulin Resistance

Year 2014, Volume: 39 Issue: 3, 443 - 450, 22.07.2014
https://doi.org/10.17826/cutf.91313

Abstract

Purpose: The protective effect of bilirubin on atherosclerotic heart disease in Gilbert's syndrome (GS) is well known. The aim of the study was to evaluate whether the atherosclerotic risk factors such as uric acid (UA), insulin resistance, glucose and lipid profiles are reduced in patients with GS compared with healthy subjects. Material and Methods: Thirty-four male and 38 female a total of 72 GS patients and a similar age group of 72 healthy individuals (34 males and 38 females) were included in the study. Both groups were between 16-45 years old and all patients were were non-smokers and drinkers. The levels of UA, lipids, glucose, insulin and C-reactive protein (CRP) were examined. HOMA-IR index were estimated. Results: Even insignificantly, GS patients had lower levels of total cholesterol whereas high-density lipoprotein was found to be higher. Conclusion: Our results shown that in GS patients, increased bilirubin levels are associated with decrease in UA, insulin, LDL, TG, and increased HDL. In GS patients, low level of UA, insulin and lipid profile may be contributed to cardioprotective effect.

References

  • So A, Thorens B. Uric acid transport and disease. J Clin Invest. 2010;120:1791-9.
  • Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003;41:1183-90.
  • Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA. 1991;266:3008-11.
  • Koenig W, Meisinger C. Uric acid, type 2 diabetes, and cardiovascular diseases: Fueling the common soil hypothesis? Clin Chem 2008;54:231-3.
  • Trkulja V, Car S. On-admission serum uric acid predicts outcomes after acute myocardial infarction: systematic review and meta-analysis of prognostic studies. Croat Med J. 2012;53:162-72.
  • Gilbert A, Lereboullet P. La cholamae simple familiale. Sem Med. 1901;21:241–8.
  • Bosma PJ, Chowdhury JR, Bakker C, Gantla S, de Boer A, Oostra BA, et al. The genetic basis of the reduced expression of bilirubin UDPglucuronosyltransferase 1 in Gilbert’s syndrome. N Engl J Med. 1995;333:1171–5.
  • Schwertner HA, Vitek L. Gilbert syndrome, UGT1A1*28 allele, and cardiovascular disease risk: possible protective effects and therapeutic applications of bilirubin. Atherosclerosis. 2008;198:1–
  • Hulsmans M, Van Dooren E, Holvoet P. Mitochondrial reactive oxygen species and risk of atherosclerosis. Curr Atheroscler Rep. 2012;14:264 Cüre E, C içek Y, Cumhur Cüre M, Yüce S, Kırbaş A, Yılmaz A. The evaluation of relationship between adiponectin levels and epicardial adipose tissue thickness with low cardiac risk in Gilbert`s syndrome: an observational study. Anadolu Kardiyol Derg. 2013;13:791-6.
  • Cüre E, Yüce S, Ciçek Y, Cüre MC. The effect of Gilbert's syndrome on the dispersions of QT interval and P-wave: an observational study. Anadolu Kardiyol Derg. 2013;13:559-65.
  • Cure MC, Cure E, Kirbas A, Cicek AC, Yuce S. The effects of Gilbert's syndrome on the mean platelet volume and other hematological parameters. Blood Coagul Fibrinolysis. 2013;24:484-8.
  • Dhaliwal G, Cornett PA, Tierney LM Jr. Hemolytic anemia. Am Fam Physician 2004;69:2599-606.
  • Osei-Bimpong A, Jury C, McLean R, Lewis SM. Point-of-care method for total white cell count: an evaluation of the HemoCue WBC device. Int J Lab Hematol. 2009;31:657-64.
  • Strassburg CP. Hyperbilirubinemia syndromes (Gilbert-Meulengracht, Crigler-Najjar, Dubin-Johnson, and Rotor syndrome). Best Pract Res Clin Gastroenterol 2010;24:555-71.
  • Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.
  • Gokcel A, Ozsahin AK, Sezgin N, Karakose H, Ertorer ME, Akbaba M, et al. High prevalence of diabetes in Adana, a southern province of Turkey. Diabetes Care. 2003;26:3031-4.
  • Yesilova Z, Serdar M, Ercin CN, Gunay A, Kilciler G, Hasimi A, et al. Decreased oxidation susceptibility of plasma low density lipoproteins in patients with Gilbert's syndrome. J Gastroenterol Hepatol. 2008;23:1556-60.
  • Tapan S, Karadurmus N, Dogru T, Ercin CN, Tasci I, Bilgi C, et al. Decreased small dense LDL levels in Gilbert's syndrome. Clin Biochem. 2011;44:300-3.
  • Boon AC, Hawkins CL, Bisht K, Coombes JS, Bakrania B, Wagner KH, et al. Reduced circulating oxidized LDL is associated with hypocholesterolemia and enhanced thiol status in Gilbert syndrome. Free Radic Biol Med. 2012;52:2120-127.
  • Fauci AS, Harrison TR. Harrison’s principles of internal medicine. McGraw-Hill Medical, 17th ed, New York. 2008:2444.
  • Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404–10.
  • Niskanen LK, Laaksonen DE, Nyyssönen K, Alfthan G, Lakka HM, Lakka TA, et al. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med. 2004;164:1546–51.
  • Syed Ikmal SI, Zaman Huri H, Vethakkan SR, Wan Ahmad WA. Potential biomarkers of insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease. Int J Endocrinol. 2013;2013:69856.
  • Al-Karkhi IH, Ibrahim AE, Yaseen AK. Levels of Insulin, IL-6 and CRP in Patients with Unstable Angina. Adv Clin Exp Med 2013;22:655-8.
  • Babacanoglu C, Yildirim N, Sadi G, Pektas MB, Akar F. Resveratrol prevents high-fructose corn syrupinduced vascular insulin resistance and dysfunction in rats. Food Chem Toxicol 2013;60:160-7.
  • Sibal L, Agarwal SC, Home PD, Boger RH. The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease. Curr Cardiol Rev. 2010;6:82-90.
  • Leiter LA, Lundman P, da Silva PM, Drexel H, Jünger C, Gitt AK. Persistent lipid abnormalities in statin-treated patients with diabetes mellitus in Europe and Canada: results of the Dyslipidaemia International Study. Diabet Med. 2011;28:1343-51.
  • Rodrigues SL, Baldo MP, Capingana P, Magalhaes P, Dantas EM, Molina Mdel C, et al. Gender distribution of serum uric acid and cardiovascular risk factors: population based study. Arq Bras Cardiol. 2012;98:13-21.
  • Bulmer AC, Blanchfield JT, Toth I, Fassett RG, Coombes JS. Improved resistance to serum oxidation in Gilbert's syndrome: a mechanism for cardiovascular protection. Atherosclerosis. 2008;199:390–6.
  • Hopkins PN, Wu LL, Hunt SC, James BC, Vincent GM, Williams RR. Higher serum bilirubin is associated with decreased risk for early familial coronary artery disease. Arterioscler Thromb Vasc Biol. 1996;16:250–5.
  • Schwertner HA, Jackson WG, Tolan G. Association of low serum concentration of bilirubin with increased risk of coronary artery. Clin Chem. 1994;40:18–23.
  • Yazışma Adresi / Address for Correspondence: Dr. Medine Cumhur Cüre University of Recep Tayyip Erdogan, School of Medicine, Department of Biochemistry, Islampasa mahallesi, 53100 R İZE Phone: +90-464-213-0491-1874 Fax: +90-464-217-0364
  • Email: medinecure@yahoo.com G eliş tarihi/Received on: 23.01.2014
  • Kabul tarihi/Accepted on:28.02.2014

Lipid Profili, Serum Ürik Asit, Glukoz ve İnsülin Direnci Üzerine Gilbert"s Sendromunun Etkileri

Year 2014, Volume: 39 Issue: 3, 443 - 450, 22.07.2014
https://doi.org/10.17826/cutf.91313

Abstract

Amaç: Gilbert"s sendromunda (GS) aterosklerotik kalp hastalığı üzerine bilirubinin koruyucu etkisi iyi bilinmektedir. Bu çalışmanın amacı ürik asit (ÜA), insülin direnci, glukoz ve lipid profilleri gibi aterosklerotik risk faktörlerinin sağlıklı bireylerle karşılaştırıldığında GS"li hastalardadüşük olup olmadığı araştırmaktır. Materyal ve Metod: 34 erkek ve 38 kadın toplam 72 GS"li hasta ve benzer yaş grubunda 72 sağlıklı birey (34 erkek ve 38 kadın) bu çalışmaya dahil edildi. Her iki grupta 16-45 yaş aralığında ve sigara ve alkol tüketimi yoktu. ÜA, lipidler, glukoz, insülin ve C-reaktif protein (CRP) seviyelerine bakıldı. HOMA-İR indeks hesaplandı. Bulgular: GS"li hastalarda ÜA 4.2 ± 0.8 mg/dL, kontrol grubunda ise ÜA is 4.8 ± 1.1 mg/dL idi. GS"li hastalarda HOMA-İR 1.8 ± 0.6, kontrol grubunda ise 2.0 ± 0.4 idi. GS"li hastalarda ÜA (p < 0.001), insülin (p = 0.021), HOMA-İR (p = 0.039), trigliserid (TG) (p = 0.005), düşük dansiteli lipoprotein (DDL) (p = 0.036) ve CRP (p = 0.006) kontrol grubuna göre anlamlı düşük seviyede bulundu. İstatistiki anlamlı olmasa bile, GS"li hastalarda total kolesterol düşük bunun aksine yüksek dansiteli lipoprotein (YDL) yüksek bulundu. Sonuç: Bizim çalışmamızın sonuçları GS"li hastalarda artmış bilirubin seviyesinin düşük ÜA, insülin, DDL, TG ve artmış YDL seviyeleri ile ilişkili olduğunu gösterdi. GS"li hastalarda, düşük seviyedeki ÜA, insülin ve lipid profili kardiyoprotektif etkiye katkı sağlıyor olabilir.

References

  • So A, Thorens B. Uric acid transport and disease. J Clin Invest. 2010;120:1791-9.
  • Johnson RJ, Kang DH, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is there a pathogenetic role for uric acid in hypertension and cardiovascular and renal disease? Hypertension 2003;41:1183-90.
  • Facchini F, Chen YD, Hollenbeck CB, Reaven GM. Relationship between resistance to insulin mediated glucose uptake, urinary uric acid clearance, and plasma uric acid concentration. JAMA. 1991;266:3008-11.
  • Koenig W, Meisinger C. Uric acid, type 2 diabetes, and cardiovascular diseases: Fueling the common soil hypothesis? Clin Chem 2008;54:231-3.
  • Trkulja V, Car S. On-admission serum uric acid predicts outcomes after acute myocardial infarction: systematic review and meta-analysis of prognostic studies. Croat Med J. 2012;53:162-72.
  • Gilbert A, Lereboullet P. La cholamae simple familiale. Sem Med. 1901;21:241–8.
  • Bosma PJ, Chowdhury JR, Bakker C, Gantla S, de Boer A, Oostra BA, et al. The genetic basis of the reduced expression of bilirubin UDPglucuronosyltransferase 1 in Gilbert’s syndrome. N Engl J Med. 1995;333:1171–5.
  • Schwertner HA, Vitek L. Gilbert syndrome, UGT1A1*28 allele, and cardiovascular disease risk: possible protective effects and therapeutic applications of bilirubin. Atherosclerosis. 2008;198:1–
  • Hulsmans M, Van Dooren E, Holvoet P. Mitochondrial reactive oxygen species and risk of atherosclerosis. Curr Atheroscler Rep. 2012;14:264 Cüre E, C içek Y, Cumhur Cüre M, Yüce S, Kırbaş A, Yılmaz A. The evaluation of relationship between adiponectin levels and epicardial adipose tissue thickness with low cardiac risk in Gilbert`s syndrome: an observational study. Anadolu Kardiyol Derg. 2013;13:791-6.
  • Cüre E, Yüce S, Ciçek Y, Cüre MC. The effect of Gilbert's syndrome on the dispersions of QT interval and P-wave: an observational study. Anadolu Kardiyol Derg. 2013;13:559-65.
  • Cure MC, Cure E, Kirbas A, Cicek AC, Yuce S. The effects of Gilbert's syndrome on the mean platelet volume and other hematological parameters. Blood Coagul Fibrinolysis. 2013;24:484-8.
  • Dhaliwal G, Cornett PA, Tierney LM Jr. Hemolytic anemia. Am Fam Physician 2004;69:2599-606.
  • Osei-Bimpong A, Jury C, McLean R, Lewis SM. Point-of-care method for total white cell count: an evaluation of the HemoCue WBC device. Int J Lab Hematol. 2009;31:657-64.
  • Strassburg CP. Hyperbilirubinemia syndromes (Gilbert-Meulengracht, Crigler-Najjar, Dubin-Johnson, and Rotor syndrome). Best Pract Res Clin Gastroenterol 2010;24:555-71.
  • Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412–9.
  • Gokcel A, Ozsahin AK, Sezgin N, Karakose H, Ertorer ME, Akbaba M, et al. High prevalence of diabetes in Adana, a southern province of Turkey. Diabetes Care. 2003;26:3031-4.
  • Yesilova Z, Serdar M, Ercin CN, Gunay A, Kilciler G, Hasimi A, et al. Decreased oxidation susceptibility of plasma low density lipoproteins in patients with Gilbert's syndrome. J Gastroenterol Hepatol. 2008;23:1556-60.
  • Tapan S, Karadurmus N, Dogru T, Ercin CN, Tasci I, Bilgi C, et al. Decreased small dense LDL levels in Gilbert's syndrome. Clin Biochem. 2011;44:300-3.
  • Boon AC, Hawkins CL, Bisht K, Coombes JS, Bakrania B, Wagner KH, et al. Reduced circulating oxidized LDL is associated with hypocholesterolemia and enhanced thiol status in Gilbert syndrome. Free Radic Biol Med. 2012;52:2120-127.
  • Fauci AS, Harrison TR. Harrison’s principles of internal medicine. McGraw-Hill Medical, 17th ed, New York. 2008:2444.
  • Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971–1992. National Health and Nutrition Examination Survey. JAMA. 2000;283:2404–10.
  • Niskanen LK, Laaksonen DE, Nyyssönen K, Alfthan G, Lakka HM, Lakka TA, et al. Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study. Arch Intern Med. 2004;164:1546–51.
  • Syed Ikmal SI, Zaman Huri H, Vethakkan SR, Wan Ahmad WA. Potential biomarkers of insulin resistance and atherosclerosis in type 2 diabetes mellitus patients with coronary artery disease. Int J Endocrinol. 2013;2013:69856.
  • Al-Karkhi IH, Ibrahim AE, Yaseen AK. Levels of Insulin, IL-6 and CRP in Patients with Unstable Angina. Adv Clin Exp Med 2013;22:655-8.
  • Babacanoglu C, Yildirim N, Sadi G, Pektas MB, Akar F. Resveratrol prevents high-fructose corn syrupinduced vascular insulin resistance and dysfunction in rats. Food Chem Toxicol 2013;60:160-7.
  • Sibal L, Agarwal SC, Home PD, Boger RH. The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease. Curr Cardiol Rev. 2010;6:82-90.
  • Leiter LA, Lundman P, da Silva PM, Drexel H, Jünger C, Gitt AK. Persistent lipid abnormalities in statin-treated patients with diabetes mellitus in Europe and Canada: results of the Dyslipidaemia International Study. Diabet Med. 2011;28:1343-51.
  • Rodrigues SL, Baldo MP, Capingana P, Magalhaes P, Dantas EM, Molina Mdel C, et al. Gender distribution of serum uric acid and cardiovascular risk factors: population based study. Arq Bras Cardiol. 2012;98:13-21.
  • Bulmer AC, Blanchfield JT, Toth I, Fassett RG, Coombes JS. Improved resistance to serum oxidation in Gilbert's syndrome: a mechanism for cardiovascular protection. Atherosclerosis. 2008;199:390–6.
  • Hopkins PN, Wu LL, Hunt SC, James BC, Vincent GM, Williams RR. Higher serum bilirubin is associated with decreased risk for early familial coronary artery disease. Arterioscler Thromb Vasc Biol. 1996;16:250–5.
  • Schwertner HA, Jackson WG, Tolan G. Association of low serum concentration of bilirubin with increased risk of coronary artery. Clin Chem. 1994;40:18–23.
  • Yazışma Adresi / Address for Correspondence: Dr. Medine Cumhur Cüre University of Recep Tayyip Erdogan, School of Medicine, Department of Biochemistry, Islampasa mahallesi, 53100 R İZE Phone: +90-464-213-0491-1874 Fax: +90-464-217-0364
  • Email: medinecure@yahoo.com G eliş tarihi/Received on: 23.01.2014
  • Kabul tarihi/Accepted on:28.02.2014
There are 34 citations in total.

Details

Primary Language English
Journal Section Research
Authors

Medine Cumhur Cüre This is me

Erkan Cüre This is me

Aynur Kırbaş This is me

Süleyman Yüce This is me

Ayşe Ertürk This is me

Publication Date July 22, 2014
Published in Issue Year 2014 Volume: 39 Issue: 3

Cite

MLA Cüre, Medine Cumhur et al. “Effects of Gilbert"s Syndrome on Lipid Profile, Levels of Serum Uric Acid, Glucose and Insulin Resistance”. Cukurova Medical Journal, vol. 39, no. 3, 2014, pp. 443-50, doi:10.17826/cutf.91313.