Gilbert's syndrome: protective effect on endothelial dysfunction

Abstract

Objective: Gilbert's syndrome (GS), is a benign condition characterized by unconjugated hyperbilirubinemia related to a decreased hepatic glucuronidating activity without symptoms and signs of liver disease or overt hemolysis. In the present study, we aimed to assess circulating levels of asymmetric dimethylarginine (ADMA), pentraxin-3 (PTX-3) and high sensitivity C-reactive protein (hs-CRP) between patients with GS and controls and determine the correlation of unconjugated bilirubin (UCB) levels with these molecules as prognostic factors for vascular risk stratification and endothelial dysfunction. Methods: Forty two patients with GS and 37 age and sex matched control subjects were enrolled in this study. The diagnosis of GS was made by unconjugated hyperbilirubinemia (1 mg/dL or > 17.1 mu mol/L) on at least two occasions with normal values of other liver function tests, normal hepatic imaging, and absence of hemolysis. Results: Serum ADMA, PTX-3 and hs-CRP levels were significantly lower in GS than the healthy controls (p = 0.037, p = 0.025 and p = 0.040, respectively). In correlation analysis, UCB was negatively correlated with ADMA, PTX-3 and hs-CRP (r = -0.239, p = 0.034; r = -0.280, p = 0.012 and r = -0.224, p = 0.047, respectively). Discussion and conclusion: The present study showed for the first time that decreased levels of ADMA, PTX-3 and hs-CRP may prove the protective effects of hyperbilirubinemia on the endothelial dysfunction.