Association Between Serum Total Bilirubin Level and Lung Function Decline in Patients with COPD: Results from a Pooled Study

• Published in: International journal of chronic obstructive pulmonary disease Vol. 17; pp. 1031 - 1039
• Main Authors: Dai, Cuiqiong, Wang, Zihui, Deng, Zhishan, Wu, Fan, Yang, Huajing, Xiao, Shan, Wen, Xiang, Zheng, Youlan, Xu, Jianwu, Lu, Lifei, Zhao, Ningning, Huang, Peiyu, Zhou, Yumin, Ran, Pixin
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2022; Dove Medical Press Ltd; Dove; Dove Medical Press
• Subjects: Analysis; Antioxidants; Bilirubin; Biomarkers; Body mass index; Care and treatment; Chronic obstructive pulmonary disease; copd; decline; Family medical history; Forced Expiratory Volume; gold stage; Humans; Lung; Lung cancer; Lung diseases; lung function; Original Research; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Questionnaires; R&D; Regression analysis; Research & development; Respiratory diseases; Smoking; Spirometry; total bilirubin; Tuberculosis; Variance analysis; China; decline; lung function; total bilirubin; GOLD stage; COPD
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S360485

Serum total bilirubin has been reported to have antioxidant properties against chronic respiratory diseases. The objective of our study is to evaluate the association of total bilirubin (TB) with annual lung function decline in COPD patients with different GOLD stages. This study used pooled data from two observational and prospective cohorts of 612 COPD patients whose TB levels were measured at baseline. The associations between TB and postbronchodilator FEV , FEV pred, FVC, FVCpred, FEV /FVC, and the rate of their decline were all determined using linear regression models in the total population and strata of GOLD stages. Serum TB was positively related to FEV and FVC in the total group (β 0.02, 95% CI 0.001~0.02, P = 0.025 and β 0.02, 95% CI 0.002~0.03, P = 0.022, respectively). Additionally, TB was inversely associated with the annual decline in FEV and FEV pred (β 4.91, 95% CI 1.68~8.14, P = 0.025 and β 0.21, 95% CI 0.06~0.36, P = 0.022, respectively) when adjusted for multivariables. After stratification, the significant associations merely persisted in COPD patients with GOLD 2 and GOLD 3-4. Increased TB level was related to less annual decline in FEV as well as FEV pred in moderate-to-severe COPD but not mild COPD, which indicated the different status of TB in different COPD severity and the possible role as potential biomarker merely in moderate-to-severe COPD. Future researches to determine whether TB could be served as biomarker for COPD and the mechanisms should be focused on some target patients with a certain disease severity.