Hakan Sarlak
Diyarbakır Military Hospital, Turkey
Title: Relationship among the HDLc, NonHDLc/HDLc ratio and Gilbert's syndrome
Biography
Biography: Hakan Sarlak
Abstract
Introduction: Gilbert's syndrome is a functional disorder of the UDP glucuronosyltransferase enzyme defect in the liver causing to decreased secretion of bilirubin to bile. As a result of this disease, serum bilirubin gets above than normal levels. In these patients, there are some studies showing lower cardiovascular risks. In this study, we aimed to investigate the relationship between laboratory results and bilirubin levels in a large number of patients with Gilbert’s syndrome.
Materials & Methods: We collected the data of 1203 Gilbert's syndrome patients and 1155 healthy control groups. The mean age of the patients and the control group were 24.1±6.2 and 23.8±5.1 years respectively (p=0.127). The total and indirect bilirubin values of the patients and control groups were 1.72±0.52 and 0.59±0.21; 0.51±1.53 and 0.44±0.19 mg/dl, respectively.
Results: The mean erythrocyte sedimentation rate (ESR) was significantly lower in patients with Gilbert's syndrome (4.5±4.7 and 5.4±3.3 mm/h, p<0.001). Neutrophil / lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) was high in patients with Gilbert syndrome than in controls (2.68±1.08 and 1.44±0.5; p<0.001 and 10.01±3.8 and 6.8±2.01; p<0.001). Hematocrit levels were similar. Hb levels were higher in patients with Gilbert's syndrome (15.7±1.18 and 15.2±0.98 g/dl, p<0.001). The average MCV values were lower in these patients (83.2±6.1 and 88.5±4.3 fl, p<0.001). Indirect bilirubin levels were associated with RDW (Red Cell Distribution Width) and neutrophil count (Pearson's r=0.141 and 0.087 respectively, p<0.001 and p=0.048). RDW (β=0.164 and p <0.001) and patient age (β=-0.091, p=0.038), were significant parameters associated with indirect bilirubin values in the regression analysis conducted in patients respectively.
Discussion: The mean erythrocyte sedimentation rate was lower in patients with Gilbert's syndrome. This is consistent with data from previous studies which stated the lower cardiovascular risk in these patients. However, verifying this information could not be obtained by the other parameters such as NLR or PLR, which reflects inflammatory conditions. Conversely, the higher NLR and PLR rates in these patients may be due to greater amount of neutrophils or platelets, compared to lymphocytes proportionately. Futhermore, having the lower level of MCV in Gilbert’s syndrome patients, lower erythrocyte volume and also higher bilirubin levels due to increased erythrocyte turnover of some patients, suggests the possibility of thalassemia intermediate forms.