| Objective:This study is intended to analyze the relationship between different types of serum bilirubin levels（total bilirubin（TBIL）,direct bilirubin（DBIL）,indirect bilirubin（IBIL））,hypertension and blood pressure through case-control study based on the epidemiological survey of hypertension in a population in northern China,and draw relevant dose response relationship diagrams,hoping to provide basis for the prevention and treatment of hypertension.Methods:This is a case control study.On site,questionnaire surveys and intravenous blood sampling were used to collect social statistical information and biochemical sample information of the study subjects.The effects of different types of serum bilirubin levels on the risk of hypertension and blood pressure changes were calculated by binary Logistic regression and generalized linear model respectively.At the same time,the dose response relationship between different types of serum bilirubin levels,hypertension and blood pressure was plotted by using the restricted cubic spline function model.Results:1.A total of 462 subjects are included in this study（hypertension:217;non-hypertension:245）,with an average age of 55.85（SD:12.47）years,and 371（80.3%）female participants.The TBIL of case group is 12.70μmol/L,the TBIL of control group is11.80μmol/L,the difference between the two groups is statistically significant（P=0.02）;In addition,the DBIL level of case group is 3.10μmol/L,the DBIL level of control group is 2.80μmol/L,the difference is not statistically significant（P=0.07）;For IBIL,the difference between the two groups（case group:9.60μmol/L,control group:8.90μmol/L）is statistically significant（P=0.02）.2.After adjusting for possible potential confounders,it was found that the risk of hypertension increased by 43%for 1-SD increase in TBIL,and the risk of hypertension in individuals with TBIL level≥17.10μmol/L was 2.18 times higher than that in individuals with TBIL level<17.10μmol/L.1-SD increase in DBIL increased the risk of hypertension by 65%.Compared with the first quantile level of DBIL,the OR of the fourth quantile was2.06（1.05,4.03）.In addition,the risk of hypertension in individuals with IBIL≥13.68μmol/L was 3.29 times higher than that in individuals with IBIL<13.68μmol/L.3.In the multifactor model,systolic blood pressure increased by 2.94 mm Hg for 1-SD increase in DBIL.The systolic blood pressure of individuals with IBIL≥13.68 was 6.47mm Hg higher than individuals with IBIL<13.68μmol/L.For diastolic blood pressure,When DBIL as a continuous variable increased by 1-SD,the change of diastolic blood pressure increased by 1.33 mm Hg.4.The dose effect relationship curve showed that there might be a weak nonlinear correlation between TBIL and the risk of hypertension(TBIL:P nonlinear=0.05).There was no evidence of nonlinear correlation between DBIL,IBIL and the risk of hypertension(DBIL:P nonlinear=0.09;IBIL:P nonlinear=0.10).For systolic blood pressure,no possible nonlinear correlation was found between any bilirubin and the risk of abnormal systolic blood pressure(TBIL:P nonlinear=0.28;DBIL:P nonlinear=0.59;IBIL:P nonlinear=0.38).Similarly,for diastolic blood pressure,it is unlikely that there is a non-linear relationship between TBIL and diastolic blood pressure(P nonlinear=0.52)or between DBIL and diastolic blood pressure(P nonlinear=0.14).Conclusion:The increased levels of TBIL and DBIL may be a risk factor for hypertension,which may be related to the changes of systolic and diastolic blood pressure caused by the changes of DBIL.It can be considered to reduce the impact of DBIL on systolic or diastolic blood pressure by reducing the binding of bilirubin,so as to achieve the purpose of preventing hypertension. |
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