Prospective Study On The Relationship Between Serum Total Bilirubin Level And Risk Of Ischemic Stroke

Background and ObjectiveIn China,stroke is one of the major diseases that endanger the health and life safety of middle-aged and elderly people.According to the survey,stroke has become the first cause of death in China,and the leading cause of disability among adults in China.Data shows that 1.7 million people die from stroke each year in our country,of which 60%-70% of the total ischemic stroke.A large number of studies have shown that serum bilirubin is the production of hemoglobin released by the lysis of old red blood cells in the body,which has long been considered as a metabolic waste.In recent years,studies have found that serum bilirubin is a powerful physiological antioxidant and anti-inflammatory properties which can inhibit lipid oxidation,prevent plaque formation,against oxidative stress mediated inflammation,atherosclerosis and ischemic disease of heart head blood-vessel.Ischemic stroke is a series of hypoxic ischemic symptoms caused by cerebral vascular occlusion or thrombosis resulting in insufficient blood supply to the brain tissue.High serum bilirubin level inhibits lipid oxidation and inhibits plaque formation and may be associated with reduced risk of ischemic stroke.This study based on 2077 villages and towns medical testing bilirubin level in the normal range of physical examination for the risk of ischemic stroke onset prospective follow-up study in order to investigate the serum total bilirubin level and rural population of ischemic cerebral stroke risk.Method4230 healthy people aged 35-75 were stratified by six villages in two townships in the South and than collect the occurrence of ischemic stroke during follow-up.Baseline survey was conducted from May to August 2009.We collect the general demographic data,physical examination and biochemical examination of the subject.Excluding 149 people with a history of stroke and cardiovascular disease,4081 people were followed-up.The 2077 people whose total bilirubin detected in the normal range were analyzed.The total population was divided into four groups based on tattoo bilirubin quartile range.The study began in September 2014 and ended in January 2016.And cox proportional risk regression model was used to calculate relative risk.ResultsFollow-up studies were conducted on average duration of approximately 5.16 person(total 10717.32 follow-up years).To the end of follow-up,a total of 88 people had a stroke,including 44 male people,44 women people.After sex,age,blood pressure,blood sugar and other confounding factors corrected,compared with Q1 crowd,the risk of ischemic stroke was significantly reduced in Q3 group.HR and 95%CI respectively 0.60(0.32-1.14).and compared with Q1 group,the risk of ischemic stroke was significantly reduced in Q4 group,HR and 95%CI respectively 0.54(0.27-1.05).But the risk of ischemic stroke wasn't go down significantly in Q2 group when compared with Q1 group.And it was found in further stratification analysis that women aged over 55 who don't smoke and don't drink the risk of ischemic stroke is reduced in the high levels of serum bilirubin levels.ConclusionThere was a correlation between high serum bilirubin level and risk reduction of ischemic stroke.High serum bilirubin level may be considered as a new indicator for evaluating the risk and prognosis of ischemic stroke.