Plasma Bilirubin and UGT1A1*28 Are Not Protective Factors Against First-Time Myocardial Infarction in a Prospective, Nested Case–Referent Setting

Background: Bilirubin, an effective antioxidant, shows a large variation in levels between individuals and has been positively associated with reduced cardiovascular disease risk. A major reason for the variability is a common promoter polymorphism, UGT1A1*28, which reduces the transcription of the enzyme that conjugates bilirubin, UDP-glucuronosyltransferase 1A1. The aim of the study was to evaluate a possible protective effect of plasma bilirubin and the UGT1A1*28 polymorphism against myocardial infarction in a prospective case-referent setting.Methods and Results: 618 subjects with a first-ever myocardial infarction (median event age 60.5 years, median lag time 3.5 years) and 1184 matched referents were studied. Plasma bilirubin was lower in cases vs. referents. Despite a strong gene-dosage effect on bilirubin levels in both cases and referents, the UGT1A1*28 polymorphism did not influence the risk of myocardial infarction. Among multiple other variables, serum iron showed one of the strongest associations with bilirubin levels.Conclusion: We found no evidence for a protective effect of the UGT1A1*28 polymorphism against myocardial infarction and consequently neither for bilirubin. The lower bilirubin levels in cases might be caused by decreased production, increased degradation or increased elimination.

Marklund, Stefan LUmeå universitet,Klinisk kemi(Swepub:umu)stma0003 (author)
Jansson, Jan-HåkanMedicinkliniken, Skellefteå lasarett (author)
Osterman, PiaUmeå universitet,Patologi(Swepub:umu)pios0001 (author)
Hallmans, GöranUmeå universitet,Näringsforskning(Swepub:umu)goha0001 (author)
Weinehall, LarsUmeå universitet,Epidemiologi och global hälsa(Swepub:umu)lawe0001 (author)
Hultdin, JohanUmeå universitet,Klinisk kemi(Swepub:umu)johu0007 (author)
Umeå universitetKlinisk kemi (creator_code:org_t)

In:CirculationPhiladelphia, PA : Lippincott Williams & Wilkins:3, s. 340-3471942-325X1942-3268

By the author/editor: Ekblom, Kim, 197 ...; Marklund, Stefan ...; Jansson, Jan-Håk ...; Osterman, Pia; Hallmans, Göran; Weinehall, Lars; show more...; Hultdin, Johan; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Health Sciences; and Public Health Gl ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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