ArticleBiomolecules2025
Bilirubin Metabolism and Thyroid Cancer: Insights from ALBI and PALBI Indices.
Article in Biomolecules, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Associations of bilirubin, albumin, and the ALBI index with gastric cancer risk: a smoking-stratified prospective cohort study in men.BMC gastroenterology · 2026Article
- Association of the Naples prognostic score with all-cause and cardiovascular mortality in U.S. patients with heart failure: a retrospective cohort study using NHANES 2001-2018.Journal of health, population, and nutrition · 2026Article
- Husbands' smoking and risk of diabetes in reproductive-aged Chinese women: a nationwide population-based cohort study.BMC public health · 2026Article
- Association of testosterone and sex hormone-binding globulin with chronic liver disease outcomes across sex and menopausal status.Biology of sex differences · 2026Article
- Reactive oxygen species and intrinsic apoptotic markers in thyroid dysfunction: Insights from experimental animal models.Open veterinary journal · 2026Article
- Association of serum uric acid and serum uric acid/creatinine ratio with metabolic dysfunction-associated fatty liver disease in young adults: a retrospective study.BMC endocrine disorders · 2026Article
- Sex-specific in the nonlinear associations of hemoglobin glycation index and all-cause mortality in the general US adult population: results from NHANES 1999-2018.Nutrition & metabolism · 2026Article
- Prostate cancer risk and antioxidant biomarkers: the age-dependent reversal of bilirubin's role.BMC urology · 2025Article
- Association between De Ritis ratio and mortality in individuals with diabetes or prediabetes: evidence from NHANES (1999-2018).European journal of medical research · 2025Article
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4 authors.
Funding
Abstract
backgroundThis study evaluated the association between bilirubin subtypes (total, indirect, and direct bilirubin) and thyroid cancer risk, with a particular focus on stratified analyses using the ALBI (Albumin-Bilirubin) and PALBI (Platelet-Albumin-Bilirubin) indices by sex, smoking and drinking status, and age under 50 years.
methodsData were obtained from 133,596 participants in the Korean Cancer Prevention Study-II (KCPS-II) cohort. During a mean follow-up period of 13.55 years, 2314 cases of thyroid cancer (ICD-10: C73) were identified. Serum bilirubin levels and ALBI and PALBI indices were analyzed using Cox proportional hazards regression models stratified by age, sex, smoking, and alcohol consumption status to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).
resultsIn women, indirect bilirubin showed the strongest inverse association with thyroid cancer risk. ALBI and PALBI indices based on indirect bilirubin also demonstrated significant associations. A 1 standard deviation (SD) increase in indirect bilirubin was associated with a decreased risk of thyroid cancer (HR: 0.92, 95% CI: 0.84-0.99), and the ALBI index similarly showed an inverse association (HR: 0.92, 95% CI: 0.87-0.99). In contrast, the PALBI index was positively associated with thyroid cancer risk (HR: 1.11, 95% CI: 1.03-1.20). Among women who had never smoked, significant associations were observed for indirect bilirubin (HR: 0.91, 95% CI: 0.83-1.00), ALBI (HR: 0.93, 95% CI: 0.86-1.00), and PALBI (HR: 1.14, 95% CI: 1.05-1.23). In analyses stratified by alcohol consumption, the PALBI index was associated with increased thyroid cancer risk in non-drinkers, former drinkers, and ever drinkers, with respective risk increases of 15%, 18%, and 9%.
conclusionsIn women, indirect bilirubin was significantly and inversely associated with thyroid cancer risk, and the ALBI and PALBI indices incorporating indirect bilirubin showed consistent results. These findings suggest that indirect bilirubin may play a critical role in the metabolic pathways underlying thyroid cancer in women.
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