• Journal of Preventive Medicine and Public Health
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• 제45권2호
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• pp.105-112
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• 2012

Objectives: Cigarette smoking is a modifiable risk factor for cardiovascular disease. Bilirubin is a potent antioxidant and its concentration decreases in smokers. However, studies about the association between cigarette smoking and bilirubin are scarce and most are limited to total bilirubin. Additionally, bilirubin is highly related to hemoglobin. Therefore, this study evaluates the association between bilirubin subtypes and cigarette smoking in healthy Korean men independently of hemoglobin. Methods: This study included 48 040 Korean men aged 30 to 87 years who visited the Korea Medical Institute for routine health examinations from January to December, 2007. The association of smoking with total, direct, and indirect bilirubin was assessed by logistic regression analysis taking into consideration differences in subjects and smoking characteristics. Results: Current smokers had lower bilirubin concentrations than never-smokers and ex-smokers. Smoking amount and duration were inversely significantly associated with total, direct, and indirect bilirubin. In a multivariable adjusted model, compared to never-smokers, the odds ratios (ORs) and 95% confidence intervals (CIs) of current smokers with the highest number of pack-years were 1.7 (1.6 to 1.9) for total, 1.5 (1.4 to 1.6) for direct, and 1.7 (1.6 to 1.9) for indirect bilirubin. After further adjustment for hemoglobin, this association became stronger (OR [95% CI], 2.1 [1.9 to 2.2] for total; 1.9 [1.8 to 2.0] for direct; 2.0 [1.9 to 2.2] for indirect bilirubin). Conclusions: In this study, bilirubin subtypes are inversely associated with smoking status, smoking amount, and smoking duration in healthy Korean men independently of hemoglobin. Further studies are needed to investigate this association in healthy Korean women.

• 대한수의학회지
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• 제14권1호
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• pp.23-27
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• 1974

Concentration of total protein, bilirubin, sodium and potassium in blood sera, and thymol turbidity of race horses, 78 males and 57 females aging from 2 to 5 years, were estimated. The results obtained were as follows: 1. Serum of race horses was low in protein concentrations as mean values of $5.48{\pm}0.77$ g/100ml. 2. Serum bilirubin was in normal range as mean values of total bilirubin, direct bilirubin and indirect bilirubin were $1.05{\pm}0.57$, $0.12{\pm}0.05$ and $0.93{\pm}0.58$ mg/100ml, respectively. 3. Mean value of serum thymol turbidity was $1.41{\pm}0.72$ S-H unit. 4. Mean values of serum sodium and potassium of race horses from Australia were $143{\pm}8.7$ and $3.85{\pm}0.53$ mEq/liter, respectively, and mean values of serum sodium and patassium of race horses from Japan were $142{\pm}9.4$ and $3.58{\pm}0.60$ mEq/liter, respectively.

• Korean Circulation Journal
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• 제53권7호
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• pp.472-479
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• 2023

Background and Objectives: The association between bilirubin and atrial fibrillation (AF) has been evaluated previously in observational studies but with contradictory results. This study evaluated the causal association between serum bilirubin level and AF using Mendelian randomization (MR) analysis. Methods: This cross-sectional study includes 8,977 participants from the Dong-gu Study. In the observational analysis, multivariate logistic regression was performed to evaluate the association between bilirubin and prevalent AF. To evaluate the causal association between bilirubin and AF, MR analysis was conducted by using the UGT1A1 rs11891311 and rs4148323 polymorphisms as instrumental variables. Results: Elevated serum bilirubin levels were associated with an increased risk for AF in observational analysis (total bilirubin: odds ratio [OR], 1.31; 95% confidence interval [95% CI], 1.15-1.48 per 1 standard deviation [SD]; direct bilirubin: OR, 1.31; 95% CI, 1.18-1.46 per 1 SD), whereas the genetically predicted serum bilirubin levels in MR analysis did not show this association (total bilirubin: OR, 1.02; 95% CI, 0.67-1.53 per 1 SD; direct bilirubin: OR, 1.03; 95% CI, 0.61-1.73 per 1 SD). Conclusions: Genetically predicted bilirubin levels were not associated with prevalent AF. Thus, the observational association between serum bilirubin levels and AF may be noncausal and affected by reverse causality or unmeasured confounding.

• 대한예방한의학회지
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• 제3권1호
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• pp.36-36
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• 1999

From January 1994 to April 1997, there was 15 survivals who was admitted to the department of internal medicine, Wonkwang Oriental Medicine' Hospital in Cheun-ju, after ingestion of paraquat, and treated with Oriental and western medicine therapy. For the patients, I investigated clinical symptoms, gastroduodenoscopy, intake by oral and parenteral route, and output by urine and stool, serum ALP, AST. ALT, Bilirubin, BUN, Creatinine level and urine analysis. On admission day, the LFT level was as follows. The serum mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin was 10.05${\pm}$2.75 KAU, 66.67${\pm}$9.88 IU／L, 43.80${\pm}$7.74 IU／L, 1.89${\pm}$1.22 ㎎／dl and 1.10${\pm}$1.14 ㎎／dl respectively. After that day, administered Gamdutang and checked the mean LFT level regullary. Until the 3rd day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 11.0l${\pm}$3.16 KAU, 56.47${\pm}$7.19 IU／L, 59.00${\pm}$7.57 IU／L, 2.54${\pm}$1.78 ㎎／dl, 1.64${\pm}$1.59 ㎎／dl respectively. From 4th day to 7th day, the mean ALP; AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.51${\pm}$3.49 KAU, 77.85${\pm}$7.17 IU／L, 58.00${\pm}$9.09 IU／L, 2.54${\pm}$1.97 ㎎／dl, and 1.80${\pm}$1.81 ㎎／dl respectively. From 8th day to 10th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.43${\pm}$3.14 KAU, 41.13${\pm}$6.49 IU／L, 50.40${\pm}$7.17 IU／L, 1.66${\pm}$1.90 ㎎／dl and 1.14${\pm}$1.50 ㎎／dl respectively. From 11th day to 14th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.30${\pm}$3.25 KAU, 31.07${\pm}$3.85 IU／L, 43.33${\pm}$5.49 IU／L, 1.62${\pm}$1.95 ㎎／dl, 1.17${\pm}$1.71 ㎎／dl respectvely. On admission day, the mean RFT level as follows. Serum BUN and Creatinine level was 28.73${\pm}$5.19 ㎎／dl and 1.82${\pm}$1.27 ㎎／dl respectively. After that day, administered Gamdutang and checked the mean RFT level regullary. Until the 3rd day, the mean BUN and Creatinine level was 32.12${\pm}$5.65 ㎎／dl and 2.31${\pm}$0.45 ㎎／dl respectively. From 4th day to 7th day, the mean BUN and Creatinine level was 31.07${\pm}$5.47 ㎎／dl and 1.92${\pm}$0.79 ㎎／dl respectively. From 7th day to 10th day, the mean BUN and Creatinine level was 17.47${\pm}$3.57 ㎎／dl and 1.33${\pm}$0.59 ㎎／dl respectively. From 11th day to 14th day, the mean BUN and Creatinine level was 11,93${\pm}$3.16 ㎎／dl, 1.27${\pm}$0.38 ㎎／dl respectively.

• 대한임상검사과학회지
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• 제50권2호
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• pp.155-163
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• 2018

빌리루빈은 내인성 항산화제로서 항염작용이 있으며, 고혈압, 당뇨병, 대사증후군 및 인슐린 저항성과 역상관 관계에 있다고 보고된다. 그러나 간 특이적 지표와 비교하여 빌리루빈과 대사증후군간의 관련성을 평가한 연구는 부족하다. 본 연구에서는 건강검진을 실시한 한국 성인남녀를 대상으로 ALT, GGT와 비교하여 총 빌리루빈과 대사증후군 유병률 사이의 관련성을 조사하고자 하였다. 이 횡단면 연구에는 2015년 3월부터 2018년 2월까지 경기도 소재 종합병원에서 건강검진을 실시한 20세 이상 성인남녀 22,568명이 포함되었다. American Heart Association/National Heart, Lung, and Blood Institute(AHA/NHLBI)의 지침에 따라 대사증후군을 진단하였다. 남녀 모두에서 대사증후군 위험요인이 없는 군보다 대사증후군 진단군에서 간 효소치가 높았으며, 총 빌리루빈과 직접 빌리루빈치는 낮게 나타났다. 남녀 모두에서 혈청 총 빌리루빈은 복부비만(r=-0.066 vs r=-0.055), 중성지방(r=-0.127 vs r=-0.136)과 약한 역상관 관계를 보였으며, 이는 ALT와 GGT보다 약한 관련성이었다. 또한 남녀 모두에서 ALT와 GGT뿐만 아니라 총 빌리루빈은 대사증후군 발생 가능성을 예측하는 지표는 아닌 것으로 나타났다.

• 대한수의학회지
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• 제32권3호
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• pp.357-364
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• 1992

Artemisia Iwayomogi Compositae) has been used clinically for jaundice, hepatitis, liver cirrhosis etc. The purposes of present study were to examine pharmacological effects of Artemisia Iwayomogi water extract(AIWE) on biochemical parameters (activities of ALP and LAP, contents of glucose, total bilirubin, total protein and albumin in serum, A/G ratio, and levels of hepatic glycogen) against hepatic injury by carbon tetrachloride($CCl_4$) in rats. The results were as follows ; 1. Increased ALP activities by $CCl_4$ were very significantly(p<0.001) decreased in AIWE posttreatment groups at 72 hours and significantly(p<0.05) decreased in AIWE pretreatment groups at 72 hours. Increased LAP activities by $CCl_4$ were significantly (p<0.05) decreased in AIWE posttreatment groups at 72 hours. A little increased total bilirubin contents by $CCl_4$ were very significantly (p<0.001) decreased in AIWE posttreatment groups at 24, 48 and 72 hours. 2. Increased glucose contents by $CCl_4$ were decreased in AIWE posttreatment groups. Decreased hepatic glycogen levels by $CCl_4$, were significantly (p<0.05) increased in AIWE posttreatment groups at 48 and 72 hours. 3. Decreased total protein contents by $CCl_4$ were significantly (p<0.05) increased in AIWE posttreatment groups at 48, 72 hours. Decreased albumin contents by $CCl_4$ were increased in proportion to numbers of AIWE treatments in AIWE pre- and posttreatement groups. Decreased A/G ratios by $CCl_4$ were significantly (p<0.05) increased in AIWE posttreatment groups at 48 hours. In conclusion, AIWE did not affect normal liver function and had hepatoprotective effects rather than direct preventive effects to $CCl_4$-induced cholestasis, damages in metabolisms of glucose, protein and bilirubin.

• 약학회지
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• 제54권4호
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• pp.270-281
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• 2010

Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.

• 대한한의학회지
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• 제34권4호
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• pp.46-55
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• 2013

Objectives: Classifying the pattern of jaundice during diagnosis will significantly improve the outcome of common KM interventions. This study aimed at determining an objective index for accurately diagnosing heat and dampness KM patterns in patients with jaundice. Methods: We systematically reviewed laboratory findings from case reports published in the scientific literature of Korean medicine. Cases were classified as following either the heat or dampness pattern. Biochemical indices were compared using a Bayesian factor (BF) analysis and standard t-tests. Results: The laboratory findings of 32 patients were evaluated. The heat pattern was observed in 17 patients and the dampness pattern in 15. No significant differences were observed between the 2 groups in terms of white blood cell count (BF=1.659); hemoglobin concentration (BF=2.627); platelet count (BF=1.019); or levels of direct bilirubin (BF=1.453), aspartate aminotransferase (BF=1.226), alanine aminotransferase (BF=1.340), alkaline phosphatase (BF=2.344), or gamma-glutamyl transpeptidase (BF=2.782). However, total bilirubin levels were significantly higher in the dampness pattern group (BF=0.854, P-value=0.070). Conclusions: Patients with high total bilirubin levels may predominantly follow the dampness pattern, while those with low levels may predominantly follow the heat pattern. These results are expected to be useful for the development of timely and efficient KM treatments as well as new integrative therapeutic approaches for jaundice. However, further studies are essential to fully validate the utility of total bilirubin as a biomarker for differentiating between heat and dampness patterns.

• Clinical and Experimental Pediatrics
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• 제56권2호
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• pp.75-79
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• 2013

Purpose: It has been reported that 10% to 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment. In this study, we aimed to identify useful predictors of therapeutic failure in children with KD. Methods: We examined 309 children diagnosed with KD at the Kyungpook National University Hospital and the Inje University Busan Paik Hospital between January 2005 and June 2011. We retrospectively reviewed their medical records and analyzed multiple parameters in responders and nonresponders to IVIG. Results: Among the 309 children, 30 (9.7%) did not respond to IVIG. They had significantly higher proportion of neutrophils, and higher levels of aspartate aminotransferase, alanine aminotransferase (ALT), total bilirubin, and N-terminal fragment of B-type natriuretic peptide than did responders. IVIG-nonresponders had a significantly longer duration of hospitalization, and more frequently experienced coronary artery lesion, and sterile pyuria. No differences in the duration of fever at initial treatment or, clinical features were noted. Conclusion: Two independent predictors (ALT${\geq}$84 IU/L, total bilirubin${\geq}$0.9 mg/dL) for nonresponse were confirmed through multivariate logistic regression analysis. Thus elevated ALT and total bilirubin levels might be useful in predicting nonresponse to IVIG therapy in children with KD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제2권1호
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• pp.59-64
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• 1999

목 적: 저자들은 백서에서 수술적으로 담도 결찰전과 결찰 4주 후에 지용성 비타민(vitamin A와 D)의 혈중 농도 변화 및 담도 결찰 후 담즙산을 투여했을 때 장관내 지용성 비타민의 흡수 변화에 대하여 알아보고자 하였다. 대상 및 방법: 생후 4주된 Sprague-Dawley rats을 대상으로 하여 수술적으로 담도를 결찰하였다. 담도 결찰 전과 결찰 4주후의 혈중 ALT, total bilirubin, vitamin A, vitamin D의 농도를 측정하였다. 백서들은 담도 결찰 후 4주간 사육하였으며, 사육기간 중 비타민만을 투요한 군, 담즙산을 투여한 군 및 UDCA를 투여한 3군으로 나누었다. 결 과: 1) 수술전 혈중 농도(평균): ALT 74.2 IU, total bilirubin 0.26 mg/dL; vitamin D 13.01 ng/mL vitamin A $0.87\;{\mu}g/mL$, total bile acids $25.16\;{\mu}mol/L$. 2) 수술 4주후 농도(평균): ALT 100.7 IU, total bilirubin 2.58 mg/dL; vitamin D 7.89 ng/mL vitamin A $1.37\;{\mu}g/mL$, total bile acids $278.22\;{\mu}mol/L$. 3) 수술후 각 군간의 혈중 vitamin A와 vitamin D의 농도 차이는 없었다. 결 론: 담도 결찰 후 vitmain A 혈중 농도는 상승 하였으며, vitamin D 농도는 감소하였다. 경구로 담즙산을 투였을 때 혈중 지용성 vitamin 농도는 투여하지 않은 경우와 차이가 없었다.