DECREASE IN SERUM BILIRUBIN AS AN UNFAVORABLE MARKER OF CARDIOVASCULAR DISORDERS

  • L. M. Strilchuk Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
  • O. O. Zimba Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
  • I. B. Zhakun Danylo Halytsky Lviv National Medical University, Lviv, Ukraine
Keywords: total bilirubin, hypobilirubinemia, coronary heart disease, haemorrhagic vasculitis, rheumatic fever, chronic rheumatic heart disease

Abstract

Serum bilirubin, the end product of heme metabolism, is a routine biochemical parameter. Bilirubin is not a liver function parameter exclusively: its concentration correlates with ischemic heart disease (IHD) risk, estimated glomerular filtration rate, retinopathy or neuropathy in diabetes mellitus, atherosclerosis etc.

The aim of this paper was to estimate the clinical value of bilirubin analysis according to literature data and own clinical observations in patients with IHD and acute and chronic rheumatologic diseases.

Materials and methods. We conducted a literature overview in Pubmed database and domestic sources and also analyzed the standard examinaions of 515 patients: 353 patients with coronary heart disease (acute forms, coronary bypass grafting – 98; acute myocardial infarction, pharmacotherapy – 75; unstable angina pectoris – 101; stable angina pectoris – 79) and 162 rheumatologic patients (haemorrhagic vasculitis – 71; rheumatic fever – 57; chronic rheumatic heart disease with valvular defects – 34). Control group consisted of 22 patients with gastroduodenal zone diseases without helicobacter (esophagitis, gastritis, peptic ulcer).

Results and discussion. It was revealed that in case of diseases with oxidative stress in their pathogenesis (acute forms of coronary heart disease, haemorrhagic vasculitis, rheumatic fever) bilirubin level was lower than in case of non-oxidative disorders (non-infectious esophagitis, gastritis, ulcer). Increase of inflammation potency was accompanied by bilirubin decrease. Correlation analysis showed that both bilirubin increase and decrease were unfavourable.

Conclusions. Bilirubin concentration correlated with parameters of cytolysis, intoxication, anemia, inflammation, carbohydrate and lipid metabolism, heart structure. Bilirubin decrease associated with the increase of stenosis of coronary arteries (left, left circumflex and anterior interventricular) in a logarithmic way. Hypobilirubinemia (< 9.6 mkmol/L) significantly more often accompanied diseases with oxidative stress in pathogenesis, acute forms and more active systemic inflammation.

Author Biographies

L. M. Strilchuk, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

PhD, Acting Associate Professor at the Department of Therapy, Medical Diagnostics and Hematology and Transfusiology

O. O. Zimba, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

PhD, Associate Professor at the Department of Internal Medicine No. 2

I. B. Zhakun, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

PhD, Associate Professor at the Department of Internal Medicine № 2

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Published
2020-09-29
How to Cite
L. M. Strilchuk, O. O. Zimba, & I. B. Zhakun. (2020). DECREASE IN SERUM BILIRUBIN AS AN UNFAVORABLE MARKER OF CARDIOVASCULAR DISORDERS. Eastern Ukrainian Medical Journal, 8(3), 268-275. Retrieved from https://eumj.med.sumdu.edu.ua/index.php/journal/article/view/121