Abstract
For long time bilirubin was considered only an ominous sign of liver diseases. However, based on recent research, bilirubin is nowadays known as a potent antioxidant molecule, possessing additional biological activities.
Bilirubin is a powerful anti-inflammatory compound, modulates number of intracelullar signaling pathways, affects protein phosphorylation. All these mechanisms may account for the protective effects of bilirubin against development of many civilization diseases.
Its salutary effects on atherogenesis are generally accepted, but its serum concentrations have negative relationship also to risk of diabetes, obesity, arterial hypertension, metabolic syndrome or non-alcoholic steatohepatitis. Based on clinical studies, it is clear now that each micromolar increase of serum bilirubin concentrations is associated with significant health benefits.
Subjects with mildly elevated serum bilirubin concentrations, such in Gilbert syndrome (benign hyperbilirubinemia), have much lower risk of these diseases, whereas those with low serum bilirubin levels are at much higher risk.