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"Bilirubin"

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"Bilirubin"

Original Article

Steatotic liver disease

Serum bilirubin levels are inversely associated with nonalcoholic fatty liver disease
Min-Sun Kwak, Donghee Kim, Goh Eun Chung, Seung Joo Kang, Min Jung Park, Yoon Jun Kim, Jung-Hwan Yoon, Hyo-Suk Lee
Korean J Hepatol 2012;18(4):383-390.
Published online December 21, 2012
DOI: https://doi.org/10.3350/cmh.2012.18.4.383
Background/Aims

Serum bilirubin exerts antioxidant and cytoprotective effects. In addition, elevated serum bilirubin levels are associated with a decreased risk of metabolic and cardiovascular diseases. However, few studies have evaluated whether serum bilirubin is associated with non-alcoholic fatty liver disease (NAFLD), which is closely associated with other metabolic diseases. The aim of this study was thus to elucidate the association between serum total bilirubin levels and NAFLD.

Methods

A cross-sectional study of 17,348 subjects undergoing a routine health check-up was conducted. Subjects positive for hepatitis B or hepatitis C virus, or with other hepatitis history were excluded. NAFLD was diagnosed on the basis of typical ultrasonographic findings and an alcohol consumption of less than 20 g/day.

Results

The mean age of the subjects was 49 years and 9,076 (52.3%) were men. The prevalence of NAFLD decreased steadily as the serum bilirubin level increased in both men and women (P<0.001 for both). Multivariate regression analysis adjusted for other metabolic risk factors showed that serum bilirubin level was inversely associated with the prevalence of NAFLD [odds ratio (OR)=0.88, 95% confidence interval (CI)=0.80-0.97]. Furthermore, there was an inverse, dose-dependent association between NAFLD and serum total bilirubin levels (OR=0.83, 95% CI=0.75-0.93 in the third quartile; OR=0.80, 95% CI=0.71-0.90 in the fourth quartile vs. lowest quartile, P for trend <0.001).

Conclusions

Serum bilirubin levels were found to be inversely associated with the prevalence of NAFLD independent of known metabolic risk factors. Serum bilirubin might be a protective marker for NAFLD.

Citations

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Editorial

Steatotic liver disease

Elevated serum bilirubin levels are inversely associated with nonalcoholic fatty liver disease
Byoung Kuk Jang
Korean J Hepatol 2012;18(4):357-359.
Published online December 21, 2012
DOI: https://doi.org/10.3350/cmh.2012.18.4.357

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Original Articles
Clinical features and prognosis of primary biliary cirrhosis in Korea
Kyung-Ah Kim, M.D.1, Sook-Hyang Jeong, M.D.2, Jung Il Lee, M.D.3, Jong Eun Yeon, M.D.4, Heon Ju Lee, M.D.5, So Young Kwon, M.D.6, U Im Chang, M.D.7, Hyun Ju Min, M.D.8
Korean J Hepatol 2010;16(2):139-146.
Published online June 25, 2010
DOI: https://doi.org/10.3350/kjhep.2010.16.2.139
Background/Aims
This study investigated the clinical features and prognosis of primary biliary cirrhosis (PBC) in Korea. Methods: Clinical data of patients diagnosed as PBC between 1997 and 2008 at eight referral hospitals were analyzed retrospectively. PBC was diagnosed based on liver function tests, presence of serum antimitochondrial antibody (AMA), and histopathological findings. Results: In total, 251 patients (218 females, 33 males, mean age 54 years) were enrolled, and the mean follow-up duration was 33.5 months. At the diagnosis, 61% of the patients were asymptomatic, 12% had decompensated liver cirrhosis, and 98% were positive for AMA. The serum alkaline phosphate (AlP) level was 2.6 times the upper limit of normal, aspartate aminotransferase was 105 U/l, and bilirubin was 2.0 mg/dl. The mean Mayo risk score was 5.5, and the Child-Pugh class was A, B, and C in 79%, 19%, and 2% of the patients, respectively. Ursodeoxycholic acid (UDCA) was used for treatment in 88% of the patients, among which 70% exhibited biochemical responses defined as normalization or a >40% decrease in AlP at 6 months. Eight deaths occurred during the follow-up, the causes were variceal bleeding, hepatic failure, and sepsis. The overall 5-year survival rate was 95%. The poor prognostic factors were being older than 60 years, high bilirubin, low albumin, ascites, high Mayo risk score, Child-Pugh class C, and initial presence of hepatic decompensation. Conclusions: Most patients diagnosed as PBC were asymptomatic, and these patients had a favorable short-term prognosis. The prognosis of PBC was dependent on the initial severity of liver disease.

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    Sook-Hyang Jeong
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    Moon Young Kim, Mee Yon Cho, Soon Koo Baik, Phil Ho Jeong, Ki Tae Suk, Yoon Ok Jang, Chang Jin Yea, Jae Woo Kim, Hyun Soo Kim, Sang Ok Kwon, Byung Su Yoo, Jang Young Kim, Min Seob Eom, Seung Hwan Cha, Sei Jin Chang
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  • Prognostic indicators in primary biliary cirrhosis: significance of revised IAHG (International Autoimmune Hepatitis Group) score
    Ho Eun Jung, Jae Young Jang, Soung Won Jeong, Jin Nyoung Kim, Hee Yoon Jang, Yun Ju Cho, Sung Ae Woo, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, Boo Sung Kim
    Clinical and Molecular Hepatology.2012; 18(4): 375.     CrossRef
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    Kyung-Ah Kim, Sook-Hyang Jeong
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Interactions of Unconjugated Bilirubin with Bile Acid by Rapid Solvent Partition
Joon Soo Hahm,Gwang Ho Mun,Hang Lak Lee,Chang Soo Eun,Joon Yong Park,Dong Soo Han,Ho Soon Choi,You Hern Ahn
Korean J Hepatol 2002;8(1):80-89.
Background/Aims
Our previous studies of ionization and solubility of unconjugated bilirubin (UCB) yielded inappropriately large differences between the two carboxylic pK'a values of UCB. These data, however, were not ideal due to crystal effects, matastability, impurities of the bilirubin, and imprecision of analyses at low UCB. Methods: The sodium salt of taurocholate (TC) was purified and dissolved in water to 100 mM. Chloroform (CHCl3) was purified by vacuum distillation. Buffers used were: citrate from pH 4 to 6, phosphate from pH 6 to 8, and borate above pH 8. All had an ionic strength of 0.10. The problems were minimized by rapid solvent partition of UCB from CHCl3 into buffered aqueous NaCl, and a new, accurate assay of low UCB in the aqueous phase which was achieved by concentrating the UCB through back extraction into small volumes of CHCl3. Results: In contrast with the crystal dissolution studies, the two pK'a value were similar. H2B0, not HB-, was the dominant UCB species in the pH range of bile (6.0 to 8.0). The aqueous solubilities of UCB were 90 to 98% less. Less than 0.01% of the bile salt partitioned into the CHCl3 phase and self-association of B= was negligible. UCB solubilities in 50 mM TC were 2 to 10% of those obtained by crystal dissolution, and, up to pH 7.9, were below the maximum UCB concentration in normal human bile. Conclusions: We suggest that the markedly increased binding of UCB with each ionization step is due to the disruption of the internal hydrogen bonds of the ionized carboxyl groups on interaction with the bile salt. We propose to extend the study of partition to determine the activity and the degradation products of calcium salts of unbound bilirubin fractions.(Korean J Hepatol 2002;8:80-89)
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