Background The inverse association between serum bilirubin, a potent antioxidant, and oxidative stress-mediated diseases such as CV disease is known. However, information is scant regarding the influence of bilirubin in relation to traditional CV risk factors on pulsatile arterial function in asymptomatic younger adults.
Methods The pulsatile arterial function, serum bilirubin, and CV risk factor variables were measured in 777 black and white subjects (71% white, 42% male) aged 18 to 44 years. Pulsatile arterial function was assessed in terms of large artery (capacitive) and small artery (oscillatory) compliances by radial artery pressure pulse contour analysis.
Results In bivariate analysis adjusted for race and gender, bilirubin related significantly and positively to large and small artery compliances and HDL cholesterol and inversely to age, body mass index, blood pressure variables, non-HDL cholesterol, triglycerides, and insulin resistance index. In multivariate analysis including race, gender, body surface area, and risk factor variables mentioned above, bilirubin did not relate to large artery compliance, without or with smoking status in the model, whereas bilirubin associated beneficially with small artery compliance (p = .01) in a model that excluded smoking status. When smoking status was included in the model, this association became less strong (p = .04), and smoking entered the model as an adverse predictor (p = .003). Further, after adjusting for age, race, and gender, nonsmokers versus smokers displayed higher bilirubin levels (p = .02).
Conclusions The observed beneficial effect of serum bilirubin on pulsatile arterial function, albeit the attenuating effect of smoking on this relationship, in asymptomatic younger adults supports the antioxidant function of bilirubin in providing protection against oxidative stress-mediated vascular dysfunction.
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