{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T21:10:07Z","timestamp":1776114607994,"version":"3.50.1"},"reference-count":0,"publisher":"Romanian Society of Gastroenterology and Hepatology","issue":"3","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JGLD"],"abstract":"<jats:p>Background and Aims: Nonalcoholic Fatty Liver Disease (NAFLD) is a chronic progressive illness with a spectrum of disease severity from steatosis to end-stage liver disease. Emerging evidence suggests total serum bilirubin levels are inversely related to the prevalence of metabolic syndrome including NAFLD. We investigated the effects of bilirubin on all-cause and cause-specific mortality stratified by NAFLD status.   Methods: We used the third National Health and Nutrition Examination Survey Cohort (1988-1994) and linked mortality dataset through 2019. Cox-regression models were constructed to assess the association between bilirubin levels categorized by quartile with all-cause and cause-specific mortality.  Results: During the median follow-up of 324 months (n=11,078), higher bilirubin levels were associated with a reduction in risk of all-cause mortality in the multivariate model (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.71-0.97 for quarter 4 [highest bilirubin levels] vs. quarter 1 [lowest bilirubin levels], p for trend=0.033). Higher bilirubin levels were associated with a lower risk for all-cause mortality in individuals with NAFLD (HR; 0.68, 95% CI: 0.55-0.86 for quarter 4, p for trend=0.010); however, this protective association with higher bilirubin levels was not noted in those without NAFLD. Higher bilirubin levels were associated with a lower risk for cardiovascular and cancer-related mortality in individuals with NAFLD.   Conclusions: In this large nationally representative sample of American adults, higher bilirubin levels in NAFLD were associated with a lower risk of all-cause mortality, which may be derived from a lower risk of cardiovascular\/cancer-related mortality.<\/jats:p>","DOI":"10.15403\/jgld-4732","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T19:17:31Z","timestamp":1695928651000},"page":"323-331","source":"Crossref","is-referenced-by-count":5,"title":["Total Bilirubin Levels in Nonalcoholic Fatty Liver Disease and All- cause and Cause-specific Mortality in US Adults"],"prefix":"10.15403","volume":"32","author":[{"given":"Kasey","family":"Moss","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brittany B","family":"Dennis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leen","family":"Naji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aijaz","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donghee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"6121","published-online":{"date-parts":[[2023,9,28]]},"container-title":["Journal of Gastrointestinal and Liver Diseases"],"original-title":[],"link":[{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/download\/4732\/1965","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/download\/4732\/1965","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T20:10:03Z","timestamp":1759781403000},"score":1,"resource":{"primary":{"URL":"https:\/\/jgld.ro\/jgld\/index.php\/jgld\/article\/view\/4732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,28]]},"references-count":0,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,9,29]]}},"URL":"https:\/\/doi.org\/10.15403\/jgld-4732","relation":{},"ISSN":["1842-1121","1841-8724"],"issn-type":[{"value":"1842-1121","type":"electronic"},{"value":"1841-8724","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9,28]]}}}