Association between Serum Total Bilirubin with Parkinson’s disease among American Adults (NHANES 1999 to 2018)

BackgroundCurrently, the existing evidence on the correlation between serum total bilirubin (STB) and Parkinson's disease (PD) is insufficient. The objective of this study was to clarify the relationship between STB levels and PD within the US (United States) population.MethodsA cross-sectional analysis was conducted using data from 25,637 participants in the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Weighted logistic regression, smooth curve fitting, subgroup analysis, and sensitivity analyses were employed to validate the research objectives.ResultsAmong all eligible subjects, the mean age was 57.11 ± 11.78 years. The prevalence of PD was 1.18 % overall, with 47.86 % in males. After adjusting for multiple variables, the odds ratio [OR] (95 % confidence interval [CI]) for PD associated with STB levels in T2 and T3 were 0.59 (95 % CI = 0.40–0.85, p = 0.006) and 0.67 (95 % CI = 0.45–0.99, p = 0.045), respectively, when compared to STB levels in T1. The analysis using restricted cubic splines (RCS) indicated an L-shaped relationship between STB levels and the prevalence of PD (p for nonlinearity = 0.004), with the lowest risk observed at 10.84 μmol/L. Comparable patterns of association were noted in subgroup analyses. Furthermore, consistent findings were derived from additional sensitivity analyses.ConclusionsOur study findings indicated that the level of STB is significantly negatively correlated with the prevalence of PD. Therefore, more prospective studies need to be designed to prove the causal relationship between them.