Background:The potential antiatherogenic role of bilirubin is generally acknowledged, so the aim of this study was to determine serum bilirubin concentrations and the prevalence of Gilbert syndrome (GS) in the Czech general population with particular reference to its relationship to the risk of myocardial infarction (MI).

Methods and Results:Biochemical markers were analyzed in 2 independent Czech post-MONICA studies (in total, n=3,311), and in 741 male MI patients. TheUGT1A1promoter gene variant (rs81753472) was analyzed in these MI patients and in the first control population cohort (n=717). Medians of serum bilirubin concentrations in the 2 Czech general population cohorts were 9.6 and 9.8 μmol/L (10.7 and 11.3 μmol/L in males, and 8.3 and 8.8 μmol/L in females; P<0.01). The prevalence of GS was 8.9%, twice as high in males compared with females (11.6 vs. 6.1%; P<0.01). TheUGT1A1(TA)_7/7promoter repeats significantly influenced serum bilirubin concentrations in the controls, but not in the MI patients. Serum bilirubin concentrations were significantly lower in MI patients (7.7 vs. 10.7 μmol/L; P<0.01), with almost 5-fold lower prevalence of GS.

Conclusions:Serum bilirubin concentrations and the prevalence of GS were determined in the Czech general population. Significantly lower serum bilirubin concentrations were observed in male MI patients.

背景：胆红素的潜在抗动脉粥样硬化作用已广为人知，因此，本研究的目的是确定捷克普通人群的血清胆红素浓度和吉尔伯特综合征（GS）患病率，特别是其与心肌梗塞风险的关系（MI）。

方法和结果：在捷克共和国进行的2项独立的MONICA研究中对生化标志物进行了分析（总计n = 3,311），并对741名男性MI患者进行了分析。的UGT1A1基因启动子变体（rs81753472）在这些心肌梗死患者和在第一对照群体的队列（N = 717）进行了分析。在两个捷克普通人群中，血清胆红素浓度的中位数分别为9.6和9.8μmol/ L（男性为10.7和11.3μmol/ L，女性为8.3和8.8μmol/ L； P <0.01）。GS的患病率为8.9％，是男性的两倍，是女性的两倍（11.6比6.1％； P <0.01）。该UGT1A1（TA） _7/7启动子重复在对照组中显着影响血清胆红素浓度，但在MI患者中则没有。MI患者的血清胆红素浓度显着降低（7.7 vs. 10.7μmol/ L； P <0.01），GS的患病率降低了近5倍。

结论：在捷克普通人群中测定了血清胆红素浓度和GS的患病率。在男性MI患者中观察到明显降低的血清胆红素浓度。