SERUM BILIRUBIN AND ANTIOXIDANT LEVELS IN FIRST DEGREE RELATIVES OF PATIENTS WITH ISCHEMIC HEART DISEASE AND NORMAL SUBJECTS
AbstractBackground: Coronary diseases appear to result from an overbalance between radical-generating,compared with radical-scavenging systems, a condition called as oxidative stress. Total antioxidant status(TAS) in human plasma reflects the balance between oxidants and antioxidants in each system. Bilirubinhas been considered an antioxidant, with capacity to remove reactive species of oxygen. Present studytried to measure the total antioxidant status of first degree relatives of patients with IHD. Study also triedto evaluate the prognostic role of serum bilirubin in disease prevention or progression. Methods: Seventyfive apparently healthy subjects in age group 20–50 years, comprising equal number of males andfemales, who were first degree relatives of ischemic heart disease patients, were included in the study.Family members were divided on the bases of their numbers, i.e., one family member (Group-A), 2 familymembers (Group-B) and more than 3 family members (Group-C). Study was cross sectional and carriedout in a period of 6 months (Jun 2008–Jan 2009). Subjects with letter of consent were taken from generalpopulation. Seventy five healthy age matched people with no history of ischemic heart disease in familywere taken as control. An overnight fasting blood sample was taken. Total antioxidant status wasdetermined using a commercially available kit. Serum bilirubin was estimated by auto analyzer. Results:Family history of ischemic heart disease with serum bilirubin showed a significant negative correlation(p<0.05). But the values of TAS failed to show any significant correlation with the family history. It wasobserved that the value of serum bilirubin was decreased significantly (p<0.05) with an increased numberof family members. Total antioxidant status failed to show any significant difference among all the threegroups. Conclusion: Our data demonstrated that reduced serum levels of bilirubin were seen in peoplewith a higher prevalence of coronary artery disease in the family. The levels of serum bilirubin showed adownward trend with an increase in number of family members affected with ischemic heart disease.Present study failed to show a definite association of total antioxidant status with family history ofischemic heart disease. Additional studies are still necessary on large number of first degree relatives toconfirm and demonstrate the association of these findings with clinical outcomes.Keywords: Ischemic heart disease, first degree relatives, total antioxidant status and bilirubin
Paffenbarger RS Jr, Hyde RT, Wing AL, Lee IM, Jung DL,
Kampert JB. The association of changes in physical-activity level
and other lifestyle characteristics with mortality among men. N
Engl J Med 1993;328:538–45.
Stewart MW, Humphriss DB, Mitcheson J, Webster J, Walker M,
Laker MF. Lipoprotein composition and serum apolipoproteins in
normoglycaemic first degree relations of non insulin dependent
diabetic patients. Atherosclerosis 1998;139:115–21.
Fukagawa NK. Aging: is oxidative stress a marker or is it causal?
Proc Soc Exp Biol Med 1999;222:293–8.
Harrison DG. Endothelial function and oxidant stress. Clin
Cardiol 1997;20(11 Supp 2):II-11–7.
Marui N, Offermann MK, Swerlick R, Kunsch C, Rosen CA,
Ahmad M, et al. Vascular cell adhesion molecule-1 (VCAM-1)
gene transcription and expression are regulated through an
antioxidant-sensitive mechanism in human vascular endothelial
cells. J Clin Invest 1993;92:1866–74.
Alho H, Leinonen J. Total antioxidant activity measured by
chemiluminescence methods. Methods Enzymol 1999;299:3–15.
Trapani L, Segatto M, Incerpi S, Pallottini V. 3-Hydroxy 3-
Methylglutaryl Coenzyme A Reductase Regulation by
Antioxidant Compounds: New Therapeutic Tools for
Hypercholesterolemia? Curr Mol Med 2011;11:790–7.
Wang XL, Rainwater DL, Vande Berg JF, Mitchell BD, Mahaney
MC. Genetic contribution to plasma antioxidant activity.
Arterioscler Thromb Vasc Biol 2001;21:1190–5.
Wei S, Gao C, Wei G, Chen Y, Zhong L, Li X. The level of
serum bilirubin associated with coronary lesion types in patients
with coronary artery disease. J Cardiovasc Med (Hagerstown)
;27: [Epub ahead of print]
Lin JP, Vitek L, Schwertner HA. Serum bilirubin and genes
controlling bilirubin concentrations as biomarkers for
cardiovascular disease. Clin Chem 2010;56:1535–43.
Kuwano T, Miura S, Shirai K, Ike A, Mori K, Shimizu T, et al.
Serum levels of bilirubin as an independent predictor of coronary
in-stentrestenosis: a new look at an old molecule. J Atheroscler
Yoshino S, Hamasaki S, Ishida S, Kataoka T, Yoshikawa A,
Oketani N, et al. Relationship between bilirubin concentration,
coronary endothelial function, and inflammatory stress in
overweight patients. J Atheroscler Thromb 2011;18:403–12.
Huang SS, Huang PH, Leu HB, Wu TC, Lin SJ, Chen JW. Serum
bilirubin predicts long-term clinical outcomes in patients with
cardiac syndrome X. Heart 2010;96:1227–32.
Ghem C, Sarmento-Leite RE, de Quadros AS, Rossetto S,
Gottschall CA. Serum bilirubin concentration in patients with an
established coronary artery disease. Int Heart J 2010;51(2):86–91.
Gul R, Anjum T, Yasmin R, Ijaz RM, Saleem M. Serum total
antioxidant status in cardiovascular patients and in healthy
individuals. Pak J Biochem Mol Biol 2010;43(3):140–3.
Djousse L, Rothman KJ, Cupples LA, Levy D, Ellison RC. Effect
of serum albumin and bilirubin on the risk of myocardial
infarction (the Framingham Offspring Study). Am J Cardiol
Djousse L, Levy D, Cupples LA, Evans JC, D’ Agostino RB,
Ellison RC. Total serum bilirubin and risk of cardiovascular
disease in the Framingham offspring study. Am J Cardiol
Madhavan M, Wattigney WA, Srinivasan SR, Berenson GS.
Serum bilirubin distribution and its relation to cardiovascular risk
in children and young adults. Atherosclerosis 1997;131:107–13.
Halliwell B, Gutteridge JMC. Free Radicals in Biology and
Medicine. 3rd ed. Oxford UK: Oxford University Press; 1999.
Wang X, Yu Y, Ji L, Liang X, Zhang T, Hai CX. Alpha-lipoic
acid protects against myocardial ischemia/reperfusion injury via
multiple target effects. Food Chem Toxicol 2011;49:2750–7.
Olisekodiaka MJ, Igbeneghu CA, Onuegbu AJ, Oduru R, Lawal
AO. Lipid, Lipoproteins, Total Antioxidant Status and Organ
Changes in Rats Administered High Doses of Cadmium Chloride.
Med Princ Pract 2011. [Epub ahead of print]
Gururajan P, Gurumurthy P, Nayar P, Chockalingam M,
Bhuvaneshwari S, Babu S, et al. Lipid profile and non-enzymic
antioxidant status in patients with acute coronary syndrome in
South India. Heart Lung Circ 2010;19(2):75–80.
Higgins M. Epidemiology and prevention of coronary heart
disease in families. Am J Med 2000;108:387–95.
Centers for Disease Control (CDC). The Surgeon General’s
Report on Reducing the Health Consequences of
Smoking: 25 Years of Progress. MMWR Morb Mortal Wkly
Rep 1989;38(Suppl 2):1–32.
Potter AS, Foroudi S, Stamatikos A, Patil BS, Deyhim F.
Drinking carrot juice increases total antioxidant status and
decreases lipid peroxidation in adults. Nutr J 2011;10:96.