الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Aim This study was conducted to assess the relation of bilirubin with obesity-related metabolic and cardiovascular risk factors and to determine the association of bilirubin levels with the risk of MS in obese subjects Patients and methods
To achieve this goal, this study was performed on 50 subjects with obesity and 50 age- and sex-matched healthy lean controls. Obese participants [BMI> 30 Kg/m2] were consecutively recruited from the Obesity Clinic at Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt. Healthy controls were recruited from the same geographic area with the same exclusion criteria. All subjects signed an informed consent, and the study was approved by the local ethics committee. The study was carried out during the year 2018-2019.Result According to our study, SBP, DBP , waist circumference, body weight, BMI, fasting insulin, HOMA-IR, serum uric acid, total cholesterol ,triglycerides, LDL-C and neutrophil : lymphocyte ratio were found to be significantly higher in cases when compared to controls (all P values < 0.05). ALT : AST ratio, serum bilirubin, GGT and HDL-C were found to be significantly lower in cases when compared to controls (all P values < 0.05). According to our study, there was significant negative association between serum bilirubin and each of waist circumference, BMI, fasting insulin, HOMA-IR, uric acid , neutrophil / lymphocyte and platelet / lymphocyte ratios. There was a significant positive association between serum bilirubin and HDL-C (P value <0.05). According to our study, there was a significant negative correlation between each of waist circumference, body weight , BMI, fasting insulin, HOMA-IR, serum uric acid, neutrophil / lymphocyte and platelet / lymphocyte ratios with serum bilirubin (all P value < 0.05). There was a significant positive correlation betweeneach of GGT and HDL-C with serum bilirubin (all P value < 0.05). By using waist circumference, body weight, BMI, fasting insulin, HOMA-IR, serum uric acid, GGT , HDL-C, neutrophil / lymphocyte and platelet / lymphocyte ratios as an independent variables and serum bilirubin as an outcome, forward stepwise linear regression analysis showed that only HDL-C and neutrophil / lymphocyte ratio were independently related to serum bilirubin (both P value <0.05). The most fit model forprediction of cardio metabolic risk factors by serum bilirubin was that of neutrophil / lymphocyte ratio followed by HOMA-IR (lowest information criteria). Conclusion : Serum total bilirubin is decreased in obese adults HDL-C and NLR are the independent predictors of low serum bilirubin. Low bilirubin levels may be considered as an early biomarker to identify future metabolic syndrome in obese subjects.