Date of Award

8-12-2024

Document Type

Restricted Access Thesis

Degree Name

MS in Physician Assistant Studies (PA)

Department

Physician Assistant Studies

First Advisor

Diana Soran, DMSc, PA-C

Abstract

Background: Gilbert’s syndrome (GS), typically considered a benign genetic condition, is signified by some transient episodes of mild hyperbilirubinemia. Evidence suggests that it may increase risk of cholelithiasis. At the same time the antioxidant and anti-inflammatory properties of bilirubin seem to provide protection against lifestyle diseases.

Purpose: This systematic review aims to comprehensively analyze the existing literature to evaluate detrimental effects of GS, particularly its association with cholelithiasis. Additionally, it explores whether elevated bilirubin levels associated with GS provide protective effects against atherosclerosis, cardiovascular diseases, type 2 diabetes mellitus (T2DM) and its complications, and assesses the overall impact on morbidity and mortality.

Methods: Articles published between 2018 and 2024 were reviewed using PubMed. The review included studies examining the relationship between GS and elevated bilirubin levels with cholelithiasis, atherosclerosis, coronary artery disease, T2DM, lipid metabolism, and obesity. Articles that were systematic reviews, editorials, meta-analyses, animal studies, and non English-language articles were excluded.

Results: The review found that the beneficial effects of GS, attributed to the antioxidant, anti-inflammatory, and anti-atherogenic properties of bilirubin, outweigh its harmful aspects, despite its association with cholelithiasis. Elevated bilirubin levels were found to provide protection against various lifestyle diseases. Conclusion: GS may offer a natural advantage due to its protective effects against lifestyle diseases. However, the impact of GS varies based on individual factors. More large-scale, multicenter prospective studies are needed to elucidate the mechanisms of bilirubin's effects and establish the long-term impacts on lifestyle diseases and overall morbidity and mortality.

Identifier

SC 11.PAS.2024.Singh.S

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