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.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology