ESPE Abstracts (2019) 92 P2-127

The bilirubin/triglycerides Ratio Predicts Changes over time in Glycated Hemoglobin in Prepubertal Healthy Children

Elsa Puerto-Carranza1, Silvia Nuevo Casals2, Berta Roca Portella3, Silvia Xargay-Torrent1, Esther Lizarraga-Mollinedo1, Berta Mas-Pares1, Francis deZegher4, Lourdes Ibañez5, Judit Bassols1, Abel López Bermejo1


1Pediatrics, Girona Biomedical Research Institute (IDIBGI), Salt, Spain. 2Pediatrics, Salut Empordà Foundation, Figueres, Spain. 3Pediatrics, Dr. Trueta University Hospital, Girona, Spain. 4Department of Development & Regeneration, University of Leuven, Leuven, Belgium. 5Endocrinology, Hospital Sant Joan de Déu, University of Barcelona Barcelona, Barcelona, Spain


Background: Low serum bilirubin and high serum triglycerides are independently associated with higher risk of developing metabolic syndrome. Both bilirubin and triglycerides can regulate insulin secretion and glucose uptake. This is a first longitudinal study in healthy children to associate bilirubin and the bilirubin/triglycerides ratio with metabolic markers.

Objectives: Analyze independent associations between bilirubin and the bilirubin/triglycerides ratio with insulin secretion and resistance and HbA1c in a cohort of healthy prepubertal children.

Subjects/Methods: A cohort of 246 apparently healthy prepubertal children (mean age 8,8 ± 1,7 years) was studied. Of those, 142 (58%) were reevaluated 4 years later (mean age 12,9 ± 1,8 years). Anthropometric (BMI, waist) and metabolic parameters (total bilirubin, triglycerides, glucose, insulin, HOMA-IR, HOMA-β and HbA1c in fasting blood samples) were assessed. Both bivariate correlations and independent associations by means of multiple linear regression analyses were performed.

Results: Total bilirubin was not associated with either HOMA-IR or HOMA-β, but it was independently associated with HbA1c, both at baseline (β= -0.208; P<0.001; R2=3.2%) and at follow-up (β= -0.261; P<0.002; R2=6.1%). Stronger independent associations were found between the bilirubin/triglycerides ratio and HbA1c, both at baseline (β= -0.294; P<0.0001; R2= 9.4%) and at follow-up (β= -0.276; P<0.001; R2=9.2%).

Conclusions: Bilirubin and specifically the bilirubin/triglycerides ratio is in prepubertal healthy children independently associated with HbA1c. Our results also indicate that the bilirubin/triglycerides ratio can predict changes in glucose tolerance over time in healthy children.