The Relationship Between Serum Bilirubin And Inflammatory Cells:a Health Check-up Association Study

BackgroundInflammation is a kind of defensive reaction that occurs in living tissue with a vascular system for inflammatory factors and local injuries.Inflammatory reaction is a common clinical pathological process,is the body's defense of a defensive behavior,involving many cells and non-cellular components of the interaction.In the course of the development of inflammation,leukocytes are both effector cells of inflammatory response and mediators of inflammation conduction.They also play a key role in the inflammatory response caused by infection or noninfection by regulating the cellular immune function.Bilirubin is a product of heme metabolism,which was usually used in the diagnosis of hemolysis,neonatal jaundice,liver and gallbladder diseases.For a longtime,bilirubin was thought to be toxic as a metabolic waste.Now a growing number of studies have shown that bilirubin is a powerful antioxidant substances,participating in lipid peroxidation protection and immune response regulation.Some studies suggest bilirubin have anti-inflammatory effects.To date,bilirubin has a definite anti-oxidant effect,physiologicala concentration of bilirubin can effectively remove oxygen free radical,prevent the formation of low density lipoprotein oxidation and oxygen free radicals,inhibit the immune response and inflammatory reaction,protect vascular endothelial cell function.but its mechanism as an anti-inflammatory substance involved in systemic inflammatory diseases is not yet clear.The relationship between serum indirect bilirubin(IBIL)and direct bilirubin and inflammatory cells is different.Previous research studies only the limited total bilirubin and the large population,but less studied the relationship between total bilirubin,direct bilirubin and indirect bilirubin and inflammatory cells.Whether there are many different opinions in some inflammatory diseases and bilirubin.Therefore,we chose the most basic inflammatory response indicators WBC,PMN,LYM,MONO to explore the association with serum bilirubin according to gender,age group observation in this study.Based on the data from 2014 to 2016 of Yankuang Group General Hospital of Shandong Province,we investigated the relationship between serum total bilirubin,direct bilirubin,indirect bilirubin and inflammatory cells.Expecting to find out the mechanism of bilirubin as an anti-inflammatory substance,which established the foundation for further study on the relationship between serum bilirubin and inflammatory cytokines.Objectives1.Analyze the relationship between serum TBIL,DBIL,IBIL and inflammatory cells;2.The relationship between serum TBIL,DBIL,IBIL and inflammatory cells was analyzed by age and sex.MethodsThis study based on the health physical examination data from January 2014 to December 2016 of ShanDong YanKuang Group General Hospital.The inclusion criteria of the study subjects:all study population older than 18 were included in this study,and the informed content is complete.Study excluded:age less than 18 years old,suffering from acute or chronic hepatitis,cirrhosis and liver cancer,bone marrow disorder and activity infection or inflammation,ALT>100 u/L or AST>100 u/L or TBIL>35.0 mu mol/L,and TBIL>20 mu mol/L object of study in patients with gallbladder polyp and gallbladder stones,suffering from serious diseases,such as heart failure,renal failure and cancer.The indicators collected include general conditions of study subjects,physical examination and laboratory test indicators.The study was conducted on the population of the total population,the gender group and the age group.In the study of the population,single factor analysis was first performed to select the variables associated with inflammation.The variable of normal distribution is not used in Spearman rank correlation analysis.Double-side hypothesis test,p<0.10 considered the difference to be statistically significant.With logarithm of inflammatory cells as dependent variable,the single factor analysis of p<0.10 variable as the independent variable in the multivariate linear regression analysis,explore after deducting the effects of other variables,the relationship between inflammatory cells and the serum bilirubin level.Double-side hypothesis test,p ? 0.05 was considered statistically significant.SPSS 24.0 software was applied to all the above statistical analysis.Results1.In this study,logarithm of white cell count as the dependent variable,serum total bilirubin,indirect bilirubin and direct bilirubin levels were used as independent variables,univariate analysis of p<0.10 variables were included in the covariate multivariate linear regression analysis.It was found that serum total bilirubin,indirect bilirubin,and direct bilirubin levels were negatively correlated with leukocyte counts.2.This study found that different gender,age composition,the relationship between serum bilirubin and inflammatory cells there are some differences found in 40 to 59-year-old population serum bilirubin and inflammatory cells in the male population was negatively correlated Relationship,while in the female population this relationship is not obvious.3.This study also found that different gender bilirubin levels and inflammatory cells in different direct bilirubin and inflammatory cells in the male population was negatively correlated,while in female population this relationship is not obvious.Conclusions1.The total population,total bilirubin,direct bilirubin and indirect bilirubin levels and inflammatory cell counts have a certain negative correlation,white cell counts,plymorphonuclear lukocyte cunts,mnocytes cunts with serum bilirubin more closely.2.Negative correlations between direct bilirubin and inflammatory cells in males were more pronounced than in females,and were most striking among those aged 40-59.