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Total serum bilirubin does not affect vascular reactivity in patients with diabetes

Sleep Disorders Program, Brigham and Women’s Hospital, Harvard Medical School

John Doupis

Joslin Diabetes Center

Shilpa Rahangdale

Sleep Disorders Program, Brigham and Women’s Hospital, Harvard Medical School

Samuel Horr

Microcirculation Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School

Atul Malhotra

Sleep Disorders Program, Brigham and Women’s Hospital, Harvard Medical School

Aristidis Veves

Microcirculation Laboratory, Beth Israel Deaconess Medical Center, Harvard Medical School, aveves{at}caregroup.harvard.edu

Abstract

Bilirubin may have a major role in the prevention of cardiovascular disease based on recent data regarding its anti-oxidant properties. We determined the relationship between total serum bilirubin and vascular reactivity in a large cohort of individuals with diabetes, a disease associated with known oxidant stress. We studied 302 individuals: 52 controls, 37 with type 1 diabetes, 213 with type 2 diabetes. High-resolution ultrasound was used to measure flow-mediated dilation (FMD; endothelium-dependent) and nitroglycerin-induced dilation (NID, endothelium-independent) of the brachial artery. Laser Doppler perfusion imaging was used to measure microvascular reactivity in the forearm skin before and after iontophoresis of acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent). Bilirubin levels were higher in the type 2 diabetes group (0.71 ± 0.34 mg/dl) compared to controls (0.56 ± 0.26 mg/dl, p < 0.0001). A weak inverse correlation was observed between bilirubin and FMD (r = –0.125, p = 0.032) and skin endothelium-dependent vasodilation (r = –0.157, p = 0.019). In multivariate analyses, however, these correlations were not statistically significant. There is no association between bilirubin levels and vascular reactivity in the macro- and microcirculation of individuals with diabetes. Bilirubin, therefore, does not correlate with predictors of cardiovascular risk in the diabetic population.

Key Words: bilirubin • diabetes • endothelial function

Vascular Medicine, Vol. 14, No. 2, 129-136 (2009)
DOI: 10.1177/1358863X08098273


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