Search

Abstract Background Bilirubin has been found to protect against overt atherosclerotic diseases, but to date, few studies have investigated the effects of bilirubin especially within the normal range on lower limb atherosclerosis. Therefore, we aimed to assess the associations of bilirubin within normal limits including total bilirubin (TB), conjugated bilirubin (CB) and unconjugated bilirubin (UCB) with lower limb atherosclerosis in Chinese patients with type 2 diabetes mellitus (T2DM). Methods 7284 T2DM patients with normal levels of serum bilirubin were included in this cross-sectional, real-world study. Patients were divided into quintiles by TB levels ( 13.99 µmol/L). Lower limb ultrasonography was conducted to detect lower limb plaque and stenosis. The association between serum bilirubin and lower limb atherosclerosis was explored by multiple logistic regression. Results A remarkable decrease in the prevalence of lower limb plaque (77.5, 75.3, 70.7, 71.7 and 67.9%) and stenosis (21.1, 17.2, 13.3, 13.0 and 12.0%) was observed across the TB quintiles. Multivariable regression analysis showed that serum TB levels were negatively correlated with higher risks of lower limb plaque and stenosis, both as a continuous variable [OR (95%CI): 0.870 (0.784–0.964), p = 0.008 for plaque; and 0.835 (0.737–0.946), p = 0.005 for stenosis] and as categorized in quintiles (p = 0.015 and 0.016 for plaque and stenosis). Interestingly, serum CB levels were only negatively correlated with lower limb stenosis [OR (95%CI): 0.767 (0.685–0.858), p

The article discusses different views on distal embolism in endovascular revascularization of lower limb arteries. Attention is drawn to the con­tribution of the drug coating of the balloon catheter to the development of distal embolization.

We performed a comprehensive evaluation of the hemostatic system and markers of endothelial dysfunction in patients with obliterating lower limb atherosclerosis involving the femoral-popliteal-tibial segment. Progressive course of obliterating atherosclerosis is associated with hypercoagulation (increased platelet aggregation activity, shortened aPTT, PT, TT, increased levels of fibrinogen, SFMCs, and D-dimer), as well as with endothelial dysfunction (increased levels of endothelin-1, von Willebrand factor, homocysteine, and Creactive protein).