Serum Bilirubin and the Risk of Chronic Obstructive Pulmonary Disease Exacerbations

Overview

Journal Respir Res

Specialty Pulmonary Medicine

Date 2017 Oct 26

PMID 29065885

Citations 13

Authors

Kirstin E Brown

Don D Sin

Helen Voelker

John E Connett

Dennis E Niewoehner

Ken M Kunisaki

Affiliations

Soon will be listed here.

Abstract

Background: Bilirubin is a potent anti-oxidant and higher serum concentrations of bilirubin have been associated with better lung function, slower lung function decline, and lower incidence of chronic obstructive pulmonary disease (COPD). We sought to determine whether elevated bilirubin blood concentrations are associated with lower risk for acute exacerbations of COPD (AECOPD).

Methods: We performed a secondary analyses of data in the Simvastatin for Prevention of Exacerbations in Moderate-to-Severe COPD (STATCOPE) and the Azithromycin for Prevention of Exacerbations of COPD (MACRO) studies. We used time-dependent multivariable Cox proportional hazards analyses, using bilirubin concentrations prior to first AECOPD as the exposure variable and time to first AECOPD as the outcome variable. STATCOPE was used for model development, with validation in MACRO.

Results: In STATCOPE (n = 853), higher bilirubin was associated with a lower but statistically insignificant hazard for AECOPD, (adjusted hazard ratio [aHR] 0.89 per log increase [95%CI: 0.74 to 1.09; p = 0.26]). In the validation MACRO study (n = 1018), higher bilirubin was associated with a significantly lower hazard for AECOPD (aHR 0.80 per log increase [95%CI: 0.67 to 0.94; p = 0.008]).

Conclusions: Bilirubin may be a biomarker of AECOPD risk and may be a novel therapeutic target to reduce AECOPD risk.

Trial Registrations: ClinicalTrials.gov NCT01061671 (registered 02 February 2010) and ClinicalTrials.gov NCT00325897 (registered 12 May 2006).

Citing Articles

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Bilirubin-associated single nucleotide polymorphism (SNP) and respiratory health outcomes: a mendelian randomization study.

Baldomero A, MacDonald D, Kaplan A, Lock E, Cho M, Bowler R Respir Res. 2023; 24(1):190.

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Du W, Guan H, Wan X, Zhu Z, Yu H, Luo P Front Endocrinol (Lausanne). 2023; 14:1121900.

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Association Between Serum Total Bilirubin Level and Lung Function Decline in Patients with COPD: Results from a Pooled Study.

Dai C, Wang Z, Deng Z, Wu F, Yang H, Xiao S Int J Chron Obstruct Pulmon Dis. 2022; 17:1031-1039.

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Association Between Serum Total Bilirubin and COPD: Results from a Cross-Sectional Study and a Bidirectional Mendelian Randomization Analysis.

Dai C, Wang Z, Yang H, Xiao S, Xu J, Deng Z Clin Epidemiol. 2022; 14:289-298.

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