Indirect unconjugated bilirubin (IBIL), making up 70-85% of circulating bilirubin, acts as a potent antioxidant and may inhibit LDL-C oxidation, thus reducing atherosclerosis and cardiovascular disease (CVD) risk.
Lower levels of IBIL have been associated with conditions such as severe carotid stenosis, coronary heart disease, liver fibrosis, and inflammation. Researchers have found that decreases in IBIL can reflect an increased severity of atherosclerosis and CVD risk. In fact, one study discovered that the cardioprotective effect of higher total bilirubin was attributed to a relative increase in IBIL.
Higher levels, on the other hand, could indicate diseases like hepatitis, cirrhosis, anemia, or genetic disorders such as Crigler–Najjar or Gilbert syndrome.
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