Povezanost serumskih vrednosti bilirubina z označevalci oksidativnega stresa in sistemskega vnetja pri bolnikih s sistemsko sklerozo

Šturm, Ajda (author), Žiberna, Lovro (mentor), Osredkar, Joško (comentor)

Sistemska skleroza je kompleksna avtoimunska bolezen, za katero so značilni vnetje, fibroza in motnje v mikrocirkulaciji, pri čemer ima oksidativni stres pomembno vlogo v njeni patofiziologiji. Bilirubin kot endogeni antioksidant bi lahko predstavljal potencialen zaščitni dejavnik, zato smo v tej raziskavi preučevali njegovo povezanost z označevalci oksidativnega stresa in vnetja pri bolnikih s sistemsko sklerozo. V retrospektivno raziskavo smo vključili 38 bolnikov s sistemsko sklerozo, pri katerih smo analizirali laboratorijske parametre, vključno z bilirubinom, označevalcem oksidativnega stresa (d-ROM), plazemsko antioksidativno kapaciteto (PAT), indeksom oksidativnega stresa (OSI), C-reaktivnim proteinom (CRP) in sedimentacijo eritrocitov (SR). Statistična analiza je vključevala deskriptivno statistiko, preverjanje normalnosti porazdelitve podatkov in korelacijsko analizo. Za dodatno oceno neodvisne povezanosti izbranih spremenljivk s koncentracijo bilirubina smo izvedli multiplo linearno regresijo. Rezultati niso pokazali statistično značilnih povezav med bilirubinom in preučevanimi parametri oksidativnega stresa, antioksidativne kapacitete ali vnetja. Ugotovili pa smo statistično značilno pozitivno korelacijo med indeksom oksidativnega stresa in CRP, ter med OSI in sedimentacijo eritrocitov, kar kaže na povezanost oksidativnega stresa in vnetnih procesov pri sistemski sklerozi. Med bilirubinom in sedimentacijo eritrocitov smo opazili negativno povezanost, ki pa ni dosegla statistične značilnosti. Multipla linearna regresija ni pokazala, da bi bila CRP ali OSI neodvisna napovednika koncentracije bilirubina. Na podlagi rezultatov sklepamo, da bilirubin pri bolnikih s sistemsko sklerozo v naši analizirani skupini ne predstavlja zanesljivega samostojnega biološkega označevalca oksidativnega stresa ali vnetja, temveč je njegova vloga verjetno bolj kompleksna in posredna. Rezultati hkrati podpirajo povezanost med oksidativnim stresom in vnetjem, kar je ključno za razumevanje patofiziologije bolezni. Nadaljnje raziskave z večjim številom bolnikov in širšim naborom bioloških označevalcev bi lahko prispevale k boljšemu razumevanju vloge bilirubina ter njegovega potencialnega kliničnega pomena.

• Language: Slovenian
• Keywords: Sistemska skleroza, bilirubin, oksidativni stres, vnetje, C-reaktivni protein, indeks oksidativnega stresa, sedimentacija eritrocitov
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: FFA - Faculty of Pharmacy
• Publisher: [A. Šturm]
• Year: 2026
• PID: 20.500.12556/RUL-184330
• UDC: 612.015+616-004(043.2)
• COBISS.SI-ID: 283770627
• Publication date in RUL: 04.07.2026

Secondary language

• Language: English
• Title: Association of serum bilirubin levels with markers of oxidative stress and systemic inflammation in patients with systemic sclerosis

Abstract

Systemic sclerosis is a complex autoimmune disease characterized by inflammation, fibrosis, and microvascular dysfunction, with oxidative stress playing a significant role in its pathophysiology. Bilirubin, as an endogenous antioxidant, may represent a potential protective factor; therefore, the aim of this study was to investigate its association with markers of oxidative stress and inflammation in patients with systemic sclerosis. Our retrospective study included 38 patients with systemic sclerosis for whom laboratory parameters were analyzed, including bilirubin, the oxidative stress marker d-ROM, antioxidant capacity (PAT), oxidative stress index (OSI), and C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Statistical analysis included descriptive statistics, normality testing, and correlation analysis. Multiple linear regression was performed to assess the independent associations of selected variables with bilirubin serum levels. The results did not demonstrate statistically significant associations between bilirubin and the studied parameters of oxidative stress, antioxidant capacity, or inflammation. In contrast, a statistically significant positive correlation was found between the oxidative stress index (OSI) and CRP, as well as between OSI and ESR, indicating an association between oxidative stress and systemic inflammation in patients with systemic sclerosis. A negative association between serum bilirubin and erythrocyte sedimentation rate was observed, although it did not reach statistical significance. Multiple linear regression analysis showed that neither CRP nor OSI were independent predictors of bilirubin levels. Based on these findings, bilirubin does not appear to be a reliable standalone biomarker of oxidative stress or inflammation in our group of patients with systemic sclerosis; rather, its role is likely more complex and indirect. The results also highlight the close interplay between oxidative stress and inflammation, which is essential for understanding the pathophysiology of the disease. Further studies with larger sample sizes and a broader range of biomarkers are needed to better define the role of bilirubin and its potential clinical relevance.

• Keywords: Systemic sclerosis, bilirubin, oxidative stress, inflammation, C-reactive protein, oxidative stress index, erythrocyte sedimentation rate