摘要目的 探讨血清直接胆红素(DBIL)与代谢综合征(MS)及其组分的关系.方法 基于山东某市职工纵向体检资料,构建2006-2011年动态体检队列,选取未患MS和至少有两次完整体检资料的5 258名调查对象纳入基线,将血清DBIL水平与MS及其组分建立多因素广义估计方程模型,在调整年龄、性别、吸烟、饮酒、ALT、AST、谷酰转肽酶、血尿酸、血尿素氮和白细胞等相关因素后,分析DBIL与MS发生的相关性,计算RR值及95％CI.结果 血清DBIL每升高1 μmol/L,MS的发病风险降低27.8％(RR=0.722,95％CI:0.654 ～ 0.797).DBIL与MS各组分关系中,血清DBIL与超重/肥胖、高脂血症的负相关关系显著.按性别和年龄分组分析,＜55岁者中,男女性血清DBIL与MS发病的负相关关系显著.结论 血清DBIL水平的升高与MS及其组分中的超重/肥胖、高脂血症呈显著负相关关系,且能降低＜55岁男女性研究对象MS发病风险.

abstractsObjective To investigate the association between serum direct bilirubin (DBIL) with metabolic syndrome (MS) and its components.Methods A dynamic health check-up cohort study was set up from 2006 to 2011.5 258 participants who satisfied the two basic rules:1) being free of MS at the 1st health check-up program;2) having at least two intact health checks were included in this study.With generalized estimating equation (GEE) model,after adjusting for items as age,gender,smoking,drinking,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,uric acid,blood urea nitrogen and white blood cells,the multivariable relative risks (RRs) of DBIL with MS and their components were analyzed.Results The RRs of DBIL for MS was 0.722 (95％ CI:0.654-0.797),which showing a dose-response.Serum DBIL was negatively associated with obesity and hyperlipidemia.Taking factors as gender and age into account,in the ＜45 years and 45-55 years groups,the RRs of DBIL for MS in females appeared as 0.516 (95％CI:0.349-0.761) and 0.435 (95％CI:0.256-0.740).And in males of ＜45 years and 45-55 years,the RRs of DBIL for MS were 0.738 (95％ CI:0.644-0.846) and 0.790 (95％ CI:0.667-0.937),respectively.Conclusions The elevated DBIL levels in serum appeared an early biomarker for MS and its components (obesity and hyperlipidemia).In particular,they may play a role in reducing the risk of MS in both females and males before 55 years of age.