Correlation Of Total Bilirubin Levels With Metabolic Syndrome And Target Organ Damage In Elderly Male Patients

Objective:To investigate the correlation between serum total bilirubin levels and metabolic syndrome and its components in elderly male patients.To discuss the correlation between serum total bilirubin levels and target organ damage in elderly male metabolic syndrome patients.Methods:430 elderly male patients were enrolled in the geriatric department of PLA Hospital during July 2016 to July 2017,including 227 patients with metabolic syndrome and 203 patients with non metabolic syndrome.At the same time,all the subjects were divided into 5 groups according to the number of metabolic diseases,including non-metabolic disease group,single metabolic disease group,double metabolic diseases group,triple metabolic diseases group and quadruple metabolic diseases group.Record the general situation,the laboratory indexes and the diseases of all the subjects.The General situation includes height,weight,body weight index(BMI),blood pressure.The laboratory indexes include serum total bilirubin(TB),liver function,blood glucose,blood lipid,blood uric acid,urea nitrogen and creatinine.Diseases include coronary heart disease,hypertension,diabetes,peripheral atherosclerosis,chronic kidney dysfunction and cerebral vascular disease.At the same time,all the subjects underwent echocardiography,the left ventricular end diastolic diameter(LVEDD),the left ventricular end systolic diameter(LVSED),the interventricular septal thickness(IVSD),the left ventricular posterior wall thickness(LVPWD)and left ventricular ejection fraction(LVEF)were recorded to calculate the left ventricular mass(LVM)and left ventricular mass index(LVMI).Results:The results of relationship between serum TB levels and prevalence of metabolic syndrome in elderly male patients.1.Compared with the non MS group:the elderly male MS group had elevated blood glucose,triglyceride and uric acid(P<0.05);and lower levels of serum TB levels(P<0.05).2.There is a difference of the serum TB levels among the five groups(p<0.001),and the serum TB levels of the double metabolic diseases group were significantly elevated than other groups(p<0.05).3.The serum TB levels were negatively correlated with hyperlipidemia,diabetes and hypertension(r=-0.181,p=0.001;r=-0.21,p=0.001;r=-0.155,p=0.001).4.Metabolic syndrome risk factors multivariate logistic regression analysis showed:serum TB levels were negatively correlated with metabolic syndrome(OR:0.943,95%CI:0.892-0.997;P=0.04).Serum TB levels were negatively correlated with hypertension(OR:0.948,95%CI:0.940-0.999;P=0.048).Serum TB levels were negatively correlated with hyperlipidemia(OR:0.943,95%CI:0.898-0.991;P=0.021).Serum TB levels were negatively correlated with diabetes(OR:0.953,95%CI:0.909-0.998;P=0.042).5.With the increase of serum TB levels,the prevalence of metabolic syndrome,hypertension,hyperlipidemia and diabetes was gradually decreased.Correlation analysis showed that serum TB levels in male MS patients were significantly correlated with Ccr(r=0.168,P=0.009),but not correlated with left ventricular mass,left ventricular mass index,urea,creatinine,prevalence of chronic renal insufficiency,chronic kidney disease stage,atherosclerosis(P>0.05).Regression analysis showed that serum TB levels were independently correlated with urea and Ccr in male MS patients(p=-0.27,95%CI:-0.48?-0.06,P=0.01;?=1.27,95%CI:0.33?2.22,P=0.01).The four quantile analysis of serum TB levels showed that there was a statistical difference of the Ccr levels among the four groups(P=0.031).Compared with Q1?25 group,the Ccr levels in Q76-100 group were significantly increased(p=0.003).Conclusion:The low levels of serum total bilirubin within physiological range may be an independent risk factor in elderly males,and the total bilirubin levels within serum physiological range is negatively correlated with the metabolic syndrome and its components hypertension,hyperlipidemia and diabetes respectively.The serum total bilirubin levels were positively related to endogenous creatinine clearance in elderly male patients with MS,suggesting that a modest increase in serum total bilirubin levels may be a protective factor for renal function in the elderly male MS patients.