[Low blood bilirubin level: possible diagnostic and prognostic importance].

The review deals with the problem of a possible physiological role of bilirubin as an endogenous anti-oxidant. The author considers low blood bilirubin level to be a risk factor of coronary artery disease (CAD) as well as a phenomenon observed in seasonal depression, diseases accompanied by non-hemolytic anemia etc. Mean bilirubin level in blood in such cases is within a narrow interval, between 0 and 10 mcmol/l. Circulating bilirubin is considered to protect human tissues from peroxidation of organic compounds, lipids first of all. Mechanisms that give rise to this phenomenon are probably diverse and not well-studied yet. Processes of the formation of free oxygen and peroxide radicals are known to take place in numerous pathological conditions. Low bilirubin level in blood may prove to be a significant marker for the evaluation of the general anti-oxidant status of the human organism. This parameter may, alone or in combination with other factors, make it possible to distinguish individuals with a risk of CAD as well as to predict the appearance or peculiarities of certain diseases.