Dataset Information

Higher serum direct bilirubin levels were associated with a lower risk of incident chronic kidney disease in middle aged Korean men.

ABSTRACT:

Background

The association between serum bilirubin levels and incident chronic kidney disease (CKD) in the general population is unknown. We aimed to examine the association between serum bilirubin concentration (total, direct, and indirect) and the risk of incident CKD.

Methods and findings

Longitudinal cohort study of 12,823 Korean male workers 30 to 59 years old without CKD or proteinuria at baseline participating in medical health checkup program in a large worksite. Study participants were followed for incident CKD from 2002 through 2011. Estimated glomerular filtration rate (eGFR) was estimated by using the CKD-EPI equation. CKD was defined as eGFR <60 mL/min per 1.73 m(2). Parametric Cox models and pooled logistic regression models were used to estimate adjusted hazard ratios for incident CKD. We observed 238 incident cases of CKD during 70,515.8 person-years of follow-up. In age-adjusted models, the hazard ratios for CKD comparing quartiles 2-4 vs. quartile 1 of serum direct bilirubin were 0.93 (95% CI 0.67-1.28), 0.88 (0.60-1.27) and 0.60 (0.42-0.88), respectively. In multivariable models, the adjusted hazard ratio for CKD comparing the highest to the lowest quartile of serum direct bilirubin levels was 0.60 (95% CI 0.41-0.87; P trend = 0.01). Neither serum total nor indirect bilirubin levels were significantly associated with the incidence of CKD.

Conclusions

Higher serum direct bilirubin levels were significantly associated with a lower risk of developing CKD, even adjusting for a variety of cardiometabolic parameters. Further research is needed to elucidate the mechanisms underlying this association and to establish the role of serum direct bilirubin as a marker for CKD risk.

SUBMITTER: Ryu S

PROVIDER: S-EPMC3930500 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Higher serum direct bilirubin levels were associated with a lower risk of incident chronic kidney disease in middle aged Korean men.

Ryu Seungho S Chang Yoosoo Y Zhang Yiyi Y Woo Hee-Yeon HY Kwon Min-Jung MJ Park Hyosoon H Lee Kyu-Beck KB Son Hee Jung HJ Cho Juhee J Guallar Eliseo E

PloS one 20140220 2

<h4>Background</h4>The association between serum bilirubin levels and incident chronic kidney disease (CKD) in the general population is unknown. We aimed to examine the association between serum bilirubin concentration (total, direct, and indirect) and the risk of incident CKD.<h4>Methods and findings</h4>Longitudinal cohort study of 12,823 Korean male workers 30 to 59 years old without CKD or proteinuria at baseline participating in medical health checkup program in a large worksite. Study par ...[more]

PMID: 24586219

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Project description:BACKGROUND:Most absorbed lead ends up in the bone, where it can be measured as a biomarker of cumulative exposure, elevations of which have been shown to predict a higher risk of coronary heart disease (CHD). Knowledge about the role of dietary patterns is critical to the development of effective interventions for the cardiovascular toxicity of cumulative lead exposure. METHODS:594 men, free of CHD at baseline, were followed from August 1991 to June 2011 in the Normative Aging Study. Bone lead concentrations were measured by K-shell-X-ray fluorescence. Dietary patterns were identified using principal components analysis. Two dietary patterns were identified: a 'prudent' pattern characterized by high intake of fruit, vegetables, legumes, tomatoes, poultry, and seafood; and a 'Western' pattern, with high intake of red meat, processed meat, refined grains, high-fat dairy products, high-energy drinks, fries, butter and eggs. Cox proportional hazard models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CHD. Effect modification on the multiplicative scale was examined through cross-product interaction terms. RESULTS:137 men developed incident CHD events during 5071 person-years of follow-up. After adjusting for age, body mass index, total energy intake, smoking status, total cholesterol to high-density lipoprotein ratio, education and occupation, an HR of incident CHD was 1.64 (95% CI: 1.27-2.11) with each doubling in patella lead concentration in the low prudent diet group (<?median prudent score); and the HR decreased to 1.07 (95% CI: 0.86-1.34) in the high prudent diet (??median prudent score) (p-for-interaction?=?0.01), suggesting protective effects of prudent diet against lead-related CHD. By contrast, the association between tibia lead and CHD was non-significantly larger in the low Western diet group (HR?=?1.43, 95% CI: 1.14-1.80) compared with the high Western diet group (HR?=?1.08, 95% CI: 0.86-1.34) (p-for-interaction?=?0.06). No significant effect modifications were detected by Western diet in the patella lead-CHD association and by prudent diet in the tibia lead-CHD association. CONCLUSIONS:Prudent diet may reduce the risk of development of CHD in relation to patella lead. However, these findings need to be interpreted with caution, given the modest sample size.

Dataset Information

Higher serum direct bilirubin levels were associated with a lower risk of incident chronic kidney disease in middle aged Korean men.

Background

Methods and findings

Conclusions

Publications

Higher serum direct bilirubin levels were associated with a lower risk of incident chronic kidney disease in middle aged Korean men.

Similar Datasets

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