ABSTRACT: Serum bilirubin may have a beneficial role in preventing oxidative changes in atherosclerosis. Limited information is available on whether serum total bilirubin is an independent confounding factor for carotid atherosclerosis {for example, intima-media thickness (IMT), plaque} measured noninvasively by B-mode ultrasonography only among elderly persons. The study subjects were 325 men aged 79 ± 8 (mean ± standard deviation) years and 509 women aged 81 ± 8 years that were enrolled consecutively from patients aged ? 60 years in the medical department. Carotid IMT and plaque were derived via B-mode ultrasonography. Multiple linear regression analysis showed that in men age (? = 0.199, p = 0.002), smoking status (? = 0.154, p = 0.006), GGT (? = -0.139, p = 0.039), and GGT (? = -0.133, p = 0.022) were significantly and independently associated with carotid IMT, and in women age (? = 0.186, p < 0.001), systolic blood pressure (? = 0.104, p = 0.046), diastolic blood pressure (? = -0.148, p = 0.004), prevalence of antihypertensive medication (? = 0.126, p = 0.004), fasting plasma glucose (? = 0.135, p = 0.003), GGT (? = -0.104, p = 0.032), estimated glomerular filtration rate, serum bilirubin (? = -0.119, p = 0.006), and prevalence of cardiovascular disease (CVD) (? = 0.103, p = 0.017) were also independently associated with carotid IMT. The odds ratios (ORs) {95% confidence interval (CI)} of increasing serum bilirubin category were negatively associated with carotid IMT ? 1.0 mm and plaque in both genders. Compared to subjects with a serum bilirubin of Quartile-1, the multivariate-OR (95% CI) of carotid plaque was 0.25 (0.11-0.57) in the Quartile-4 male group, and 0.41 (0.21-0.78) in the Quartile-2 female group, 0.51 (0.26-0.98) in the Quartile-3 female group, and 0.46 (0.24-0.89) in the Quartile-4 female group. Our data demonstrated an independently negative association between serum bilirubin and carotid atherosclerosis in both genders.
