Volume 23 Issue 7
Jul.  2025
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Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(7): 1123-1126
WANG Hengjie, ZHU Xiaowei, JI Duxin, CHEN Yan, ZHANG Chao, LIU Shihua, ZHONG Ping, CAO Li. Correlation between serum bilirubin levels and motor symptoms in Parkinson' s disease[J]. Chinese Journal of General Practice, 2025, 23(7): 1123-1126. doi: 10.16766/j.cnki.issn.1674-4152.004079
Citation: WANG Hengjie, ZHU Xiaowei, JI Duxin, CHEN Yan, ZHANG Chao, LIU Shihua, ZHONG Ping, CAO Li. Correlation between serum bilirubin levels and motor symptoms in Parkinson' s disease[J]. Chinese Journal of General Practice, 2025, 23(7): 1123-1126. doi: 10.16766/j.cnki.issn.1674-4152.004079
shu

Correlation between serum bilirubin levels and motor symptoms in Parkinson' s disease

doi: 10.16766/j.cnki.issn.1674-4152.004079
  • 1.

    Department of Neurology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou, Anhui 234000, China

Funds:

 202204295107020063

 AHWJ2022b106

  • Received Date: 2024-09-19
    Available Online: 2025-10-25
    Abstract
  •   Objective   To investigate the relationship between serum bilirubin levels and clinical symptoms (motor and non-motor symptoms) of Parkinson' s disease (PD), and to provide a theoretical basis for unraveling the pathogenesis of PD and searching for potential biological markers.   Methods   A retrospective analysis was conducted on clinical data from 102 PD patients and 102 healthy controls (HC) treated at Suzhou Hospital of Anhui Medical University between July 2021 and July 2024. The PD patients were divided into the early-stage group (65 patients) and the moderate-late-stage group (37 patients) according to Hoehn-Yahr staging. The levels of total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) were compared between the PD and HC groups, as well as between the early- and middle-late-stage groups. In addition, the relationships between serum bilirubin levels and the age of the PD patients, motor symptoms [unified Parkinson' s disease rating scale (UPDRS)-Ⅲ scores, Berg balance scale] and non-motor symptoms (Montreal cognitive assessment scale, Hamilton depression scale) were analyzed.   Results   Among the 102 patients with PD (50 males and 52 females), the median age was [71 (64, 76)] years. Compared with the HC group, the PD group had significantly higher serum TBIL and DBIL (P < 0.05). The levels of TBIL [(16.04±6.73) μmol/L vs. (13.41±4.07) μmol/L, P=0.035] and IBIL [(11.01±5.05) μmol/L vs. (9.16±2.73) μmol/L, P=0.045] in the moderate-late-stage group were higher than those in the early-stage group. In PD patients, Spearman correlation analysis showed that the severity of motor symptoms (UPDRS-Ⅲ score) was positively correlated with DBIL (rs=0.325, P < 0.001).   Conclusion   The serum levels of TBIL and DBIL in PD patients were significantly increased compared to healthy controls and were correlated with motor symptoms. DBIL may serve as a potential biomarker for assessing disease progression of PD.

     

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    • References(27)
  • [1]
    ZHU J Q, CUI Y S, ZHANG J J, et al. Temporal trends in the prevalence of Parkinson' s disease from 1980 to 2023: a systematic review and meta-analysis[J]. Lancet Healthy Longev, 2024, 5(7): e464-e479. doi: 10.1016/S2666-7568(24)00094-1
    [2]
    刘浩宇, 朋文佳, 芈静, 等. 1990—2019年全球帕金森病疾病负担的APC分析[J]. 中华全科医学, 2024, 22(1): 154-157. doi: 10.16766/j.cnki.issn.1674-4152.003353

    LIU H Y, PENG W J, MI J, et al. APC analysis of the global disease burden of Parkinson' s disease from 1990 to 2019[J]. Chinese Journal of General Practice, 2024, 22(1): 154-157. doi: 10.16766/j.cnki.issn.1674-4152.003353
    [3]
    CHAKRABARTI S, BISAGLIA M. Oxidative stress and neuroinflammation in Parkinson' s disease: the role of dopamine oxidation products[J]. Antioxidants(Basel), 2023, 12(4): 955. DOI: 10.3390/antiox12040955.
    [4]
    DIONÍSIO P A, AMARAL J D, RODRIGUES C M P. Oxidative stress and regulated cell death in Parkinson' s disease[J]. Ageing Res Rev, 2021, 67: 101263. DOI: 10.1016/j.arr.2021.101263.
    [5]
    SADIQ I Z. Free radicals and oxidative stress: signaling mechanisms, redox basis for human diseases, and cell cycle regulation[J]. Curr Mol Med, 2023, 23(1): 13-35. doi: 10.2174/1566524022666211222161637
    [6]
    LIM D W, LEE J E, LEE C, et al. Natural products and their neuroprotective effects in degenerative brain diseases: a comprehensive review[J]. Int J Mol Sci, 2024, 25(20): 11223. DOI: 10.3390/ijms252011223.
    [7]
    焦倩, 姜宏. 帕金森病病因与发病机制研究现状及其诊治意义[J]. 青岛大学学报(医学版), 2021, 57(2): 159-162.

    JIAO Q, JIANG H. Current research on etiology and pathogenesis of Parkinson's disease and significance of its diagnosis and treatment[J]. Journal of Qingdao University(Medical Sciences), 2021, 57(2): 159-162.
    [8]
    TAHAVVORI A, GARGARI M K, YAZDANI Y, et al. Involvement of antioxidant enzymes in Parkinson' s disease[J]. Pathol Res Pract, 2023, 249: 154757. DOI: 10.1016/j.prp.2023.154757.
    [9]
    MA L L, SUN L, WANG Y X, et al. Association between HO-1 gene promoter polymorphisms and diseases (review)[J]. Mol Med Rep, 2022, 25(1): 29. DOI: 10.3892/mmr.2021.12545.
    [10]
    PRZYBYLSKI P, ŻEBROWSKI M, WITKOWSKI W, et al. Antioxidant activity of bilirubin in micellar and liposomal systems is pH-dependent[J]. Antioxidants(Basel), 2024, 13(4): 426. DOI: 10.3390/antiox13040426.
    [11]
    BIANCO A, DVOŘÁK A, CAPKOVÁ N, et al. The extent of intracellular accumulation of bilirubin determines its anti-or pro-oxidant effect[J]. Int J Mol Sci, 2020, 21(21): 8101. DOI: 10.3390/ijms21218101.
    [12]
    VITEK L, HINDS T D J R, STEC D E, et al. The physiology of bilirubin: health and disease equilibrium[J]. Trends Mol Med, 2023, 29(4): 315-328. doi: 10.1016/j.molmed.2023.01.007
    [13]
    MARTÍNEZ A, LÓPEZ-RULL I, FARGALLO J A. To prevent oxidative stress, what about protoporphyrin Ⅸ, biliverdin, and bilirubin?[J]. Antioxidants(Basel), 2023, 12(9): 1662. DOI: 10.3390/antiox12091662.
    [14]
    HIRVONEN O P, LEHTI M, KYRÖLǍINEN H, et al. Heme oxygenase-1 and blood bilirubin are gradually activated by oral D-glyceric acid[J]. Antioxidants(Basel), 2022, 11(12): 2319. DOI: 10.3390/antiox11122319.
    [15]
    JAYANTI S, MORETTI R, TIRIBELLI C, et al. Bilirubin: a promising therapy for Parkinson' s disease[J]. Int J Mol Sci, 2021, 22(12): 6223. DOI: 10.3390/ijms22126223.
    [16]
    中华医学会神经病学分会帕金森病及运动障碍学组, 中国医师协会神经内科医师分会帕金森病及运动障碍专业. 中国帕金森病的诊断标准(2016版)[J]. 中华神经科杂志, 2016, 49(4): 268-271.

    Chinese society of Parkinson' s disease and movement disorders, Parkinson' s disease and movement disorder section of neurologist branch of Chinese medical doctor association. Diagnostic criteria Parkinson' s disease in China (2016 edition)[J]. Chinese Journal of Neurology, 2016, 49(4): 268-271.
    [17]
    赵媛, 刘向, 杨国锋. 血清CD73和帕金森病患者运动障碍相关性研究[J]. 医学研究杂志, 2024, 53(1): 75-79.

    ZHAO Y, LIU X, YANG G F. Correlation between serum CD73 and motor dysfunction in patients with Parkinson's Disease[J]. Journal of Medical Research, 2024, 53(1): 75-79.
    [18]
    JAYANTI S, VÍTEK L, TIRIBELLI C, et al. The role of bilirubin and the other "yellow players" in neurodegenerative diseases[J]. Antioxidants(Basel), 2020, 9(9): 900. DOI: 10.3390/antiox9090900.
    [19]
    ZHANG F H, CHEN L H, JIANG K W. Neuroinflammation in bilirubin neurotoxicity[J]. J Integr Neurosci, 2023, 22(1): 9. DOI: 10.31083/j.jin2201009.
    [20]
    SUN W H, ZHENG J H, MA J J, et al. Increased plasma heme oxygenase-1 levels in patients with early-stage Parkinson' s disease[J]. Front Aging Neurosci, 2021, 13: 621508. DOI: 10.3389/fnagi.2021.621508.
    [21]
    LIU H W, GONG L N, LAI K, et al. Bilirubin gates the TRPM2 channel as a direct agonist to exacerbate ischemic brain damage[J]. Neuron, 2023, 111(10): 1609-1625. e6 doi: 10.1016/j.neuron.2023.02.022
    [22]
    ALAHMAD M, ISBEA H, SHITAW E, et al. Nox2-trpm2 coupling promotes Zn2+ inhibition of complex Ⅲ to exacerbate ros production in a cellular model of Parkinson' s disease[J]. Sci Rep, 2024, 14(1): 18431. DOI: 10.1038/s41598-024-66630-9.
    [23]
    FEI L, LIANG Y T, KINTSCHER U, et al. Coupling of mitochondrial state with active zone plasticity in early brain aging[J]. Redox Biol, 2024, 79: 103454. DOI: 10.1016/j.redox.2024.103454.
    [24]
    KAZEMI D, HAJISHAH H, CHADEGANIPOUR A S. Association of total bilirubin with motor signs in early Parkinson' s disease in LRRK2 variant carriers[J]. J Mol Neurosci, 2022, 72(11): 2338-2344. doi: 10.1007/s12031-022-02067-x
    [25]
    GROFIK M, CIBULKA M, OLEKSAKOVA J, et al. Oxidative stress parameters and their relation to motor subtype of Parkinson' s disease and levodopa treatment status[J]. Gen Physiol Biophys, 2023, 42(1): 77-85. doi: 10.4149/gpb_2022051
    [26]
    JIN J N, LIU X, LI M J, et al. Association between serum bilirubin concentration and Parkinson' s disease: a meta-analysis[J]. Chin Med J(Engl), 2020, 134(6): 655-661.
    [27]
    QIN X L, ZHANG Q S, SUN L, et al. Lower serum bilirubin and uric acid concentrations in patients with Parkinson' s disease in China[J]. Cell Biochem Biophys, 2015, 72(1): 49-56. doi: 10.1007/s12013-014-0402-x
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