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Annals of Medicine Volume 50, 2018 - Issue 1
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Original Article

Direct, indirect and total bilirubin and risk of incident coronary heart disease in the Dongfeng-Tongji cohort

Xuefeng LaiDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Qin FangDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Liangle YangDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Xuguang ChenDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Hao WangDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Lin MaDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Wenting GuoDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Miao LiuDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Handong YangDepartment of Cardiology and Epidemiology, Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, ChinaView further author information
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Ce ZhangDepartment of Cardiology and Epidemiology, Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, ChinaView further author information
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Xiulou LiDepartment of Cardiology and Epidemiology, Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, ChinaView further author information
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Xinwen MinDepartment of Cardiology and Epidemiology, Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, ChinaView further author information
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Jing YuanDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Mei-an HeDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Tangchun WuDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; View further author information
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Xiaomin ZhangDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Correspondence[email protected]
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Pages 16-25 | Received 28 May 2017, Accepted 05 Sep 2017, Published online: 18 Sep 2017

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Yu Ren, Bin Wei, Yanpeng Song, Heng Guo, Xianghui Zhang, Xinping Wang, Yizhong Yan, Jiaolong Ma, Kui Wang, Mulatibieke Keerman, Jingyu Zhang, Rulin Ma, Jia He & Shuxia Guo. (2021) Factor Analysis of Metabolic Syndrome and Its Relationship with the Risk of Cardiovascular Disease in Ethnic Populations in Rural Xinjiang, China. International Journal of General Medicine 14, pages 4317-4325.
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Hui Han, Qingtao Yu, Nina Qin, Bin Song, Yan Meng, Zuojing Feng, Zhaoping Li & Liyong Chen. (2024) Non-linear associations of circulating total bilirubin concentration with the risk of nonalcoholic fatty liver disease and all-cause mortality. Annals of Hepatology 29:2, pages 101177.
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Zulihuma Seyiti, Long Yang, Abudushalamu Kasimujiang, Tuohutasheng Dejite, Xue-Feng Shan & Xiao-Ming Gao. (2023) Predictive value of serum creatinine and total bilirubin for long-term death in patients with ischemic heart disease: A cohort study. PLOS ONE 18:11, pages e0294335.
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Jessica R Pickett, Yuao Wu, Lucia F Zacchi & Hang T Ta. (2023) Targeting endothelial vascular cell adhesion molecule-1 in atherosclerosis: drug discovery and development of vascular cell adhesion molecule-1–directed novel therapeutics. Cardiovascular Research 119:13, pages 2278-2293.
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Huijuan Jin, Qiwei Peng, Min Li, Shuai Sun, Jinghua Zhou, Jichuan Hu, Ming Huang, Xinglong Chen, Yanan Li, Yifan Zhou, Yan Wan, Candong Hong, Shengcai Chen & Bo Hu. (2023) Supra‐Blan 2 t score as a multisystem‐based risk score to predict poor 3‐month outcome in acute ischemic stroke patients with intravenous thrombolysis . CNS Neuroscience & Therapeutics.
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Takumi Noda, Kentaro Kamiya, Nobuaki Hamazaki, Kohei Nozaki, Takafumi Ichikawa, Masashi Yamashita, Shota Uchida, Emi Maekawa, Tasuku Terada, Jennifer L. Reed, Minako Yamaoka-Tojo, Atsuhiko Matsunaga & Junya Ako. (2023) Prognostic value of liver damage assessed through direct bilirubin levels and skeletal muscle weakness in patients with heart failure. Heart & Lung 60, pages 87-94.
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Yongchao Wu, Xiaoqi Sun, Haoying Li, Xi Chu, Yucong Xue, Jiaying Qi, Qingzhong Jia, Xue Han, Li Chu, Shengjiang Guan & Xiangting Wang. (2023) 6-Gingerol attenuates arsenic trioxide-induced liver injury by inhibiting pyroptosis and ROS-NLRP3 inflammatory signaling pathway: Based on network pharmacology analysis and experiment verification. Journal of Functional Foods 105, pages 105551.
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Lu Qin, Lin Li, Hongzhen Fan, Yongsheng Gu, Weiliang He, Kaihua Zhang, Yingru Sun, Wannian Zhao, Xiaoli Niu, Ci Wei, Litao Li & Hebo Wang. (2022) Longitudinal Associations Between Serum Bilirubin Level and Carotid Atherosclerosis Plaque in a Health Screening Population. Angiology 74:5, pages 452-460.
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Ye-Xuan Cao, Hui-Hui Liu, Sha Li, Meng Zhang, Yuan-Lin Guo, Na-Qiong Wu, Cheng-Gang Zhu, Qian Dong, Jie Qian & Jian-Jun Li. (2023) Circulating Total Bilirubin and Long-Term Prognosis in Patients With Previous Myocardial Infarction. JACC: Asia 3:2, pages 242-251.
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Long Yang, Xia Dong, Baiheremujiang Abuduaini, Nueraihemaiti Jiamali, Zulihuma Seyiti, Xue-Feng Shan & Xiao-Ming Gao. (2023) Development and validation of a nomogram to predict mortality risk in patients with ischemic heart disease. Frontiers in Cardiovascular Medicine 10.
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Qingling SuHongyu Chen, Shanshan DuYiquan DaiCheng ChenTianmin He (何天敏)Ruimei Feng, Tao TaoZhijian Hu, Hongwei ZhaoPingfan GuoWeimin Ye. (2023) Association Between Serum Bilirubin, Lipid Levels, and Prevalence of Femoral and Carotid Atherosclerosis: A Population-Based Cross-Sectional Study. Arteriosclerosis, Thrombosis, and Vascular Biology 43:1, pages 136-145.
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Chen Ying, Cun-Fei Liu, De-Qun Guo, Zheng-Ren Du & Yan-Jin Wei. (2023) Predictive values of bilirubin for in-hospital adverse events in patients with ST-segment elevation myocardial infarction after primary percutaneous coronary intervention. Clinics 78, pages 100306.
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Jing Wu, Jiali Su, Yangyang Wang, Jianfeng Chen, Yuanyuan Shang & Jing Li. (2022) Association between total bilirubin and bone mineral density level in adolescents. BMC Musculoskeletal Disorders 23:1.
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Chun-Hua Jin, Jun-Wei Wang, Jiang-Feng Ke, Jing-Bo Li, Mei-Fang Li & Lian-Xi Li. (2022) Low-normal serum unconjugated bilirubin levels are associated with late but not early carotid atherosclerotic lesions in T2DM subjects. Frontiers in Endocrinology 13.
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Xiao-ling Li, Cun-rui Zhao, Chen-liang Pan, Gaxue Jiang & Bo Zhang. (2022) Role of bilirubin in the prognosis of coronary artery disease and its relationship with cardiovascular risk factors: a meta-analysis. BMC Cardiovascular Disorders 22:1.
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Lei Zuo, Jun Huang, Hongyue Zhang, Bing Huang, Xiaoyi Wu, Li Chen, Sujian Xia, Xiaomei Dong & Guang Hao. (2022) Dose-Response Association Between Bilirubin and Cardiovascular Disease: A Systematic Review and Meta-analysis. Angiology 73:10, pages 911-919.
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Rui Zhang, Yana Bai, Ruonan Wang, Zhao Bai, Jingli Yang, Yarong Chen, Jing Li, Lulu Xu, Siyu Li, Yujia Hu, Mengmei Wang & Zhiyuan Cheng. (2022) Elevated serum bilirubin may significantly reduce coronary heart disease risk in females: A prospective cohort study. Nutrition, Metabolism and Cardiovascular Diseases 32:3, pages 648-657.
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Qiwei Peng, Rentang Bi, Shengcai Chen, Jiefang Chen, Zhifang Li, Jianzhuang Li, Huijuan Jin & Bo Hu. (2021) Predictive value of different bilirubin subtypes for clinical outcomes in patients with acute ischemic stroke receiving thrombolysis therapy. CNS Neuroscience & Therapeutics 28:2, pages 226-236.
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Chaoxiu Li, Wenying Wu, Yumeng Song, Shuang Xu & Xiaomei Wu. (2022) The Nonlinear Relationship Between Total Bilirubin and Coronary Heart Disease: A Dose-Response Meta-Analysis. Frontiers in Cardiovascular Medicine 8.
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Yu Liu, Peng Zhu, Wei Wang, Xiaosheng Tan, Chuanqiao Liu, Yingshan Chen, Rongjuan Pei, Xue Cheng, Mi Wu, Qing Guo, Hongmei Liang, Zhihui Liang, Jia Liu, Yang Xu, Xiongwen Wu & Xiufang Weng. (2021) Mucosal‐Associated Invariant T Cell Dysregulation Correlates With Conjugated Bilirubin Level in Chronic HBV Infection. Hepatology 73:5, pages 1671-1687.
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. (2021) Monocytes to high-density lipoproteins ratio as an indicator of inflammation and oxidative stress in patients with various conditions of the gallbladder. The Journal of V. N. Karazin Kharkiv National University, Series "Medicine":41.
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L. M. Strilchuk, O. O. Zimba & I. B. Zhakun. (2020) DECREASE IN SERUM BILIRUBIN AS AN UNFAVORABLE MARKER OF CARDIOVASCULAR DISORDERS. Eastern Ukrainian Medical Journal 8:3, pages 268-275.
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Xiaoxiao Tao, Jianwei Wu, Anxin Wang, Chenghua Xu, Zhimin Wang & Xingquan Zhao. (2019) Lower Serum Indirect Bilirubin Levels are Inversely Related to Carotid Intima-Media Thickness Progression. Current Neurovascular Research 16:2, pages 148-155.
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Chenbo Xu, Mengya Dong, Yangyang Deng, Lisha Zhang, Fuxue Deng, Juan Zhou & Zuyi Yuan. (2019) Relation of Direct, Indirect, and Total bilirubin to Adverse Long-term Outcomes Among Patients With Acute Coronary Syndrome. The American Journal of Cardiology 123:8, pages 1244-1248.
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Oscar Coltell, Eva M. Asensio, José V. Sorlí, Rocio Barragán, Rebeca Fernández-Carrión, Olga Portolés, Carolina Ortega-Azorín, Raul Martínez-LaCruz, José I. González, Vicente Zanón-Moreno, Ignacio Gimenez-Alba, Montserrat Fitó, Emilio Ros, Jose M. Ordovas & Dolores Corella. (2019) Genome-Wide Association Study (GWAS) on Bilirubin Concentrations in Subjects with Metabolic Syndrome: Sex-Specific GWAS Analysis and Gene-Diet Interactions in a Mediterranean Population. Nutrients 11:1, pages 90.
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Li Zhang, Chunmei Zhang, Zhaowei Meng, Lu Gong, Chongjie Pang, Xiangxiang Liu, Qing Zhang, Qiyu Jia & Kun Song. (2019) Serum bilirubin is negatively associated with white blood cell count. Clinics 74, pages e775.
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Miao Liu, Jianhua Wang & Yao He. (2018) The U-Shaped Association between Bilirubin and Diabetic Retinopathy Risk: A Five-Year Cohort Based on 5323 Male Diabetic Patients. Journal of Diabetes Research 2018, pages 1-7.
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