World Journal of Medical Sciences 1 (2): 93-94, 2006 ISSN 1817-3055 © IDOSI Publications, 2006 Corresponding Address: Dr. Simmi Kharb, 1447, Sector 1, Urban Estate, Rohtak -124001, Haryana, India 93 Association of Serum Concentration of Total Bilirubin and Low Density Lipoprotein Cholesterol with Myocardial Infarction Simmi Kharb Department of Biochemistry, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India Abstract: We examined serum bilirubin and low density lipoprotein cholesterol (LDL-C) as possible risk factors in 27 patients of myocardial infarction and 50 healthy individuals served as control. An inverse relationship between increase in total bilirubin and serum levels of LDL-C was observed. There is possibility of bilirubin playing a role in the pathogenesis of coronary heart disease through LDL-C levels. Key words: Bilirubin low density lipoprotein myocardial infarction INTRODUCTION estimated before starting thrombolytic therapy. Serum Oxidative modification of low density lipoprotein kinase (CK) were also determined to assess the liver cholesterol (LDL-C) as a causative agent in atherogenesis functions [5]. Those individuals with deranged liver leading to coronary heart disease (CHD) has recently functions were excluded from the present project. Results been documented [1]. It is not known whether bilirubin were statistically analysed using student’s t-test and has a role in preventing CHD; however, recent studies regression analysis was carried out. indicate an inverse correlation between total bilirubin plasma concentration and prevalence of CHD [2]. RESULTS Bilirubin is a naturally occurring antioxidant and could as such have a role in protecting lipids and lipoproteins Observations were categorized into five groups against oxidation and against plaque formation in ranging from serum total bilirubin levels from 0.2 to > 1.5 human beings [2]. The antioxidant protection of LDL mg (Table 1). However, the healthy range for total by endogenous metabolic generation of bilirubin from bilirubin was presumed to be 0.2-0.8 mg % for total haemoglobin breakdown has also been elucidated [2]. bilirubin. An inverse relationship could be observed with Strong evidence indicates that high LDL concentration increase in serum bilirubin and serum levels of LDL-C in initiate atherogenesis and promote atherosclerosis at case of MI (r = -1.005, p<0.001). Whereas in healthy every stage, low bilirubin could be associated with control a significant positive correlation was observed increase in oxidised lipids and lipoproteins [1, 2]. Since (r = 3.22, p<0.001). bilirubin production and excretion is a continuous process, the present study is therefore aimed at estimating LDL-C a causative agent in atherogoenic process in relation to various normal levels of serum total bilirubin in patients with CHD. MATERIALS AND METHODS Twenty seven cases of acute myocardial infarction (MI) admitted in Intensive Cardiac Care Unit at Postgraduate Institute of Medical Sciences, Rohtak (India) and 50 healthy volunteers were included in the present study. Serum total bilirubin [3] and serum LDL-C [4] were AST, ALT, lactate dehydrogenase (LDH) and creatine Table 1: Bilirubin and LDL cholesterol levels Total bilirubin LDL-C (mg%) Group (mg%) mean mean No. of cases Control 0.7±0.45 101.69±22.95* 50 MI 0.9±0.48 134.22±50.58* 27 Range (i) 0.2-0.4 147.5 2 (ii) 0.5-0.7 145.88 8 (iii) 0.8-1.0 141.18 11 (iv) 1.1-1.5 114.67 3 (v) >1.5 141.35 3 *Mean ± SD