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Association Between Total Bilirubin Levels and Cardio-metabolic Risk Factors Related to Obesity


Mervat M El-Eshmawy*, Nancy Mahsoub, Mohamed Asar and Ibrahim Elsehely   Pages 1 - 7 ( 7 )


Background: The link between bilirubin and cardiometabolic outcomes has been previously identified with positive health effects of mild hyperbilirubinaemia. On the other hand, recent evidence has suggested an association between low circulating bilirubin levels and obesity. This study was conducted to assess the association of total bilirubin levels with metabolic and cardiovascular risk factors related to obesity.

Methods: A total of 50 obese adults and 50 healthy controls matched for age and sex were enrolled in this study. Anthropometric measurements, fasting glucose, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR), HOMA- β (%), lipids profile, monocyte to lymphocyte ratio (MLR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), uric acid, gamma glutamyl transpeptidase (GGT), AST/ALT ratio and total bilirubin were assessed.

Results: Total bilirubin, high density lipoprotein cholesterol (HDL-C) and AST/ALT ratio were significantly lower, whereas fasting insulin, HOMA-IR, total cholesterol, triglycerides, low density lipoprotein cholesterol, NLR, uric acid and GGT were significantly higher in obese adults than in healthy controls. Bilirubin was negatively associated with body mass index, waist circumference, fasting insulin, HOMA-IR, NLR, PLR, uric acid, and positively associated with HDL-C. HDL-C and NLR were the independent predictor variables of total bilirubin.

Conclusion: Among all the studied cardio-metabolic risk factors, HDL-C and NRL are the most closely associated variables with total bilirubin levels in obese adults.


Bilirubin, HDL-C, HOMA-IR, NRL, uric acid, obesity.


Internal Medicine Department, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University,, Clinical Pathology Department, Faculty of Medicine, Mansoura University,, Internal Medicine Department, Mansoura New General Hospital, Ministry of Health,, Internal Medicine Department, Mansoura Specialized Medical Hospital, Faculty of Medicine, Mansoura University

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