循环中总胆红素与自然人群血脂谱及动脉粥样硬化指数相关性分析  

Association of circulating total bilirubin with plasma lipids and atherosclerosis risk in the general population

作　　者：闫保娥 韩拓 巩红 马维冬 朱敏杰 张春艳[2] 周静[1] YAN Baoe;HAN Tuo;GONG Hong;MA Weidong;ZHU Minjie;ZHANG Chunyan;ZHOU Jing(Department of Cardiovascular Medicine,Yan'an University Affiliated Hospital,Yan'an 716000,China;Department of Cardiovascular Medicine,The Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China;Department of Health Management,The Second Affiliated Hospital)

机构地区：[1]延安大学附属医院心血管内科,陕西延安716000 [2]西安交通大学第二附属医院心血管内科,陕西西安710004 [3]西安交通大学第二附属医院健康管理部,陕西西安710004

出　　处：《延安大学学报(医学科学版)》2025年第1期25-31,36,共8页Journal of Yan'an University:Medical Science Edition

基　　金：陕西省自然科学基金面上项目(2023-JC-YB-709);延安市科技计划项目(2022SLSFGG-025);延安大学附属医院科学技术研究发展计划项目(2021PT-06)。

摘　　要：目的探究循环中总胆红素(total bilirubin,TBIL)水平与健康体检人群中血脂异常及动脉粥样硬化指数之间的关联性。方法收集2020年5月至2020年12月西安交通大学第二附属医院健康体检数据,记录其临床资料及相关实验室检查结果,并计算血浆致动脉硬化指数(atherogenic index of plasma,AIP)、三酰甘油-葡萄糖指数(triglyceride-glucose index,TyG)。根据TBIL三分位数由低到高分为G1~G3组,基于倾向性评分对3组患者年龄、性别、体质指数及冠心病、高血压、糖尿病、脂肪肝病史进行匹配。单因素ANOVA比较组间患者血脂水平,Spearman相关性与广义线性模型分析TBIL与AIP及TyG指数之间关联性。结果与G1组相比,G2、G3组总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)水平逐渐减低,呈现剂量反应关系,差异有统计学意义(P<0.01)。Spearman相关性分析显示,AIP指数与直接胆红素(DBIL)呈显著负相关(r=-0.0671,P<0.05);TyG指数与TBIL、DBIL呈显著负相关(r=-0.0637,P<0.05;r=-0.1645,P<0.0001)。广义线性模型回归分析显示,与G1组相比,G2组与G3组循环中TBIL水平与AIP(β=-0.030,P<0.05;β=-0.060,P<0.001)、TyG指数呈显著负相关(β=-0.078,P<0.05;β=-0.134,P<0.001)。随着TBIL水平增加,AIP与TyG指数显著降低,呈现剂量-效应关系(P<0.001)。结论健康人群循环中TBIL水平与高脂血症及动脉粥样硬化风险呈负相关,总胆红素可能参与调节血脂异常、动脉粥样硬化及胰岛素抵抗。Objective To investigate the association between circulating levels of total bilirubin(TBIL)and dyslipidemia and atherosclerotic index in a healthy physical examination population.Methods The physical examination data of the Second Affiliated Hospital of Xi'an Jiaotong University from May 2020 to December 2020 were collected.The clinical data and related laboratory examination results were recorded,and the atherogenic index of plasma(AIP)and triglyceride-glucose index(TyG)were calculated.According to the TBIL tertiles from low to high,the patients were divided into groups G1 to G3.Based on the propensity score,the age,sex,body mass index,and history of coronary heart disease,hypertension,diabetes and fatty liver were matched among the three groups.One-way ANOVA was used to compare patients'blood lipid levels between groups.Spearman correlation and generalized linear model were used to analyze the correlation between TBIL and AIP and TyG index.Results Compared with the G1 group,the total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)and triacylglycerol(TG)levels were gradually reduced in the G2 and G3 groups,showing a dose-response relationship with statistically significant differences(P<0.01).Spearman correlation analysis showed that the AIP index was significantly and negatively correlated with direct bilirubin(DBIL)(r=-0.0671.P<0.05);the TyG index was significantly and negatively correlated with TBIL and DBIL(r=-0.0637,P<0.05;r=-0.1645,P<0.0001).Generalized linear model regression analysis showed that compared to the G1 group,circulating TBIL levels were significantly negatively correlated with AIP(β=-0.030,P<0.05;β=-0.060,P<0.001)and TyG index(β=-0.078,P<0.05;β=-0.134,P<0.001)in the G2 and G3 groups.As TBIL levels increased,AIP and TyG index decreased significantly,showing a dose-effect relationship(P<0.001).Conclusion Circulating TBIL levels are negatively associated with hyperlipidemia and atherosclerosis risk in healthy populations,and total bilirubin may be involved in regulating dyslipide

关 键 词：总胆红素 血脂异常 动脉粥样硬化 血浆致动脉硬化指数 三酰甘油-葡萄糖指数 

分 类 号：R589.2[医药卫生—内分泌]