Total bilirubin and bilirubin-to-triglycerides ratio predict changes in glycated hemoglobin in healthy children

Front Endocrinol (Lausanne). 2023 Dec 1:14:1303597. doi: 10.3389/fendo.2023.1303597. eCollection 2023.

Abstract

Objective: Bilirubin and triglycerides can regulate insulin secretion and glucose uptake. The aim of our study is to analyze associations between total bilirubin (TB) and the bilirubin-to-triglycerides ratio (BTR) with metabolic markers in healthy prepubertal children.

Methods: Subjects were 246 healthy children (mean age 8), of whom 142 (58%) were reevaluated 4 years later (mean age 12). The subjects were stratified according to age into three groups (<7.8 years; 7.8-9.6 years; and >9.6 years; n=82 each) at baseline and into two groups (<12.9 years and ≥12.9 years; n=71 each) at follow-up. Anthropometrics and laboratory parameters [TB and its fractions (direct and indirect bilirubin), triglycerides, HDL-cholesterol, glucose, insulin, HOMA-IR, HOMA-B and glycated hemoglobin (HbA1c)] were assessed at both baseline and follow-up.

Results: TB and BTR showed independent and negative association with baseline and follow-up HbA1c. These associations were stronger for BTR and in the highest age group. No independent associations were observed with HOMA-IR or HOMA-B.

Conclusion: TB and BTR are independently associated with HbA1c and predict its changes over time in healthy children. Our results indicate that TB and BTR may be useful parameters in studies of glucose tolerance in healthy children.

Keywords: bilirubin; children; glycated hemoglobin; pediatrics; triglycerides.

MeSH terms

  • Bilirubin*
  • Child
  • Glucose
  • Glycated Hemoglobin
  • Humans
  • Insulin*
  • Triglycerides

Substances

  • Glycated Hemoglobin
  • Triglycerides
  • Bilirubin
  • Insulin
  • Glucose

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. EP-C is an Investigator of the Rio Hortega Fund (CM18/00236; National Institute of Health Carlos III, Spain), AG-V is a predoctoral Investigator of the pFIS Fund (FI18/00144; National Institute of Health Carlos III, Spain); BM-P is a predoctoral Investigator of the pFIS Fund (FI20/00138; National Institute of Health Carlos III, Spain). GC-B is an Investigator of the Sara Borrell Fund (CD19/00172; National Institute of Health Carlos III, Spain). FZ is a Clinical Investigator of the Clinical Research Council of the University Hospital Leuven, Belgium. LI is a Clinical Investigator of CIBERDEM (Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas). JB is an Investigator of the Miguel Servet Fund (CPII17/00013; National Institute of Health Carlos III, Spain). AL-B is an Investigator of the I3 Fund for Scientific Research (Ministry of Science and Innovation, Spain). The study was supported by grants from the Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III, Madrid, Spain (PI20/00399 to JB and PI19/00451 and PI22/00366 to AL-B), projects co-funded by FEDER (Fondo Europeo de Desarrollo Regional).