Association between serum bilirubin and the progression of carotid atherosclerosis in type 2 diabetes

Inkuk Lee, Hyeok Hee Lee, Yongin Cho, Young Ju Choi, Byung Wook Huh, Byung Wan Lee, Eun Seok Kang, Seok Won Park, Bong Soo Cha, Eun Jig Lee, Yong Ho Lee, Kap Bum Huh

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Objective: This study investigated whether serum bilirubin levels can predict the progression of carotid atherosclerosis in individuals with type 2 diabetes mellitus (T2DM). Methods: This observational study included 1,381 subjects with T2DM in whom serial measurements of carotid intima-media thickness (CIMT) were made at 1-to 2-year intervals for 6–8 years. The progression of carotid atherosclerosis was defined as newly detected plaque lesions on repeat ultrasonography. After dividing total serum bilirubin levels into tertiles, the association between total serum bilirubin at baseline and plaque progression status was analyzed. Results: Among 1,381 T2DM patients, 599 (43.4%) were categorized as having plaque progression in their carotid arteries. Those with plaque progression were significantly older; showed a higher prevalence of hypertension, abdominal obesity, and chronic kidney disease; and had a longer duration of T2DM, higher levels of total cholesterol (TC), triglycerides, and insulin resistance, and lower total bilirubin concentrations than those with no plaque progression. When total serum bilirubin levels were divided into tertiles, the highest tertile group was younger than the lowest tertile group, with higher levels of TC and high-density lipoprotein cholesterol. Multiple logistic regression analysis demonstrated that higher serum bilirubin levels were associated with a significantly lower risk of CIMT progression (odds ratio, 0.584; 95% confidence interval, 0.392–0.870; p=0.008). Age (p<0.001), body mass index (p=0.023), and TC (p=0.019) were also associated with the progression of carotid atherosclerosis in T2DM patients. Conclusion: Total serum bilirubin is independently associated with progression of atherosclerosis in the carotid arteries in T2DM patients.

Original languageEnglish
Pages (from-to)195-204
Number of pages10
JournalJournal of Lipid and Atherosclerosis
Issue number1
Publication statusPublished - 2020 Jan

Bibliographical note

Publisher Copyright:
© 2020 The Korean Society of Lipid and Atherosclerosis.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine


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