Inverse associations of serum bilirubin with high sensitivity C-reactive protein, glycated hemoglobin, and prevalence of type 2 diabetes in middle-aged and elderly Japanese men and women

Aim: The aim of this study was to examine the association of serum bilirubin, an endogenous antioxidant, with serum high sensitivity C-reactive protein (hs-CRP) level, HbA(1c), and the prevalence of type 2 diabetes in middle-aged and elderly Japanese men and women (n = 12,400). Methods: Analysis of covariance and logistic regression analysis were used to estimate geometric means of hs-CRP and HbA(1c) and odds ratios of prevalent diabetes according to bilirubin concentrations, respectively, with statistical adjustment for behavioral factors and liver enzymes. Results: Geometric means of hs-CRP and HbA(1c) were progressively lower with increasing concentrations of serum bilirubin in men and women each. An inverse association between serum bilirubin and HbA(1c) was slightly attenuated after adjustment for hs-CRP, but still remained highly significant (trend P = 0.0004 in men and trend P = 10(-5) in women). Multivariate-adjusted odds ratios of prevalent diabetes for the lowest to highest quintiles of serum total bilirubin were 1.00, 1.00, 0.73, 0.80, and 0.73 (trend P = 0.002), without adjustment for hs-CRP, and 1.00, 1.04, 0.76, 0.86, and 0.79 (trend P = 0.01), with adjustment for hs-CRP. Conclusions: Higher concentrations of serum bilirubin probably confer protection against the development of type 2 diabetes. (C) 2010 Elsevier Ireland Ltd. All rights reserved.