Plasma bilirubin and gamma-glutamyltransferase activity are inversely related in dyslipidemic patients with metabolic syndrome: Relevance to oxidative stress |
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Authors: | Philippe Giral Vlad Ratziu Philippe Couvert Alain Carrié Anatol Kontush Xavier Girerd M John Chapman |
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Institution: | aUnités de Prévention Cardiovasculaire, Service d’Endocrinologie-Métabolisme, Assistance Publique/Hopitaux de Paris, Groupe Hospitalier Pitié-Salpétrière – Université Pierre et Marie Curie, France;bService d’hépatologie, Gastroentérologie, Assistance Publique/Hopitaux de Paris, Groupe Hospitalier Pitié-Salpétrière – Université Pierre et Marie Curie, France;cDyslipoproteinemia and Atherosclerosis Research Unit, UMRS 939, National Institute for Health and Medical Research (INSERM) and Pierre et Marie Curie University (UPMC – Paris VI), France;dService de Biochimie, Assistance Publique/Hopitaux de Paris, Groupe Hospitalier Pitié-Salpétrière – Université Pierre et Marie Curie, France |
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Abstract: | BackgroundSubnormal levels of plasma bilirubin levels are associated with premature coronary artery disease and cardiovascular morbidity. Plasma gamma-glutamyltransferase (GGT) activity is linked to bilirubin level in hepatic disease and elevated GGT is equally associated with hepatic steatosis, a frequent feature of metabolic syndrome (MS). In order to assess the potential relationship between GGT activity and bilirubin levels in subjects exhibiting features of the metabolic syndrome, we determined circulating bilirubin levels and GGT activity in a cohort of dyslipidemic patients.Methods and resultsThis cross-sectional study involved patients (n = 1433) displaying atherogenic dyslipidemia in primary prevention referred to our Prevention Center. Among these patients, 25% presented with MS as defined by recent NCEP ATP III criteria. Circulating levels of transaminases, as well as GGT activity, were elevated in MS patients; by contrast, bilirubin concentrations were significantly lower in such patients as compared to those lacking this syndrome (p < 10–4 for all comparisons). Comparisons of patient groups on the basis of the number of MS criteria which were concomitantly present revealed a progressive decrease in mean bilirubin levels; this reduction paralleled a progressive increase in mean GGT activity as a function of the number of MS components in the overall population (p value for trend < 10–4).ConclusionElevation in systemic GGT activity, which is characterized by extended generation of ROS, together with potentially deficient bilirubin-mediated antioxidative capacity of plasma, may therefore constitute key components of the systemic oxidative stress typical of metabolic syndrome. |
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Keywords: | Metabolic syndrome Gamma-glutamyltransferase Bilirubin Oxidation |
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