Investigation of joint hypermobility in individuals with hyperbilirubinemia

Abstract

Objective: Benign joint hypermobility syndrome refers to hypermobile individuals with musculoskeletal symptoms in the absenceof any systemic rheumatic disease; its prevalence is approximately 0.5%. In animal studies, bilirubin has been shown to reducefibrosis induced by bleomycin. It has been suggested that bilirubin leads to hypermobility that affects the structure or function ofcollagen. In addition, our observation is that hypermobility occurs more often in patients with indirect hyperbilirubinemia. In thisstudy, we aimed to evaluate hypermobility in patients with indirect hyperbilirubinemia.Material and Methods: We recruited 120 consecutive patients with indirect hyperbilirubinemia from a tertiary gastroenterology outpatient clinic and examined them for hypermobility. Hypermobility was evaluated using the Beighton criteria, and other relevant clinicalfindings were recorded. In addition, a group of healthy individuals (n=107) without hyperbilirubinemia were included as controls.Results: The mean ages of the patients and controls were 33.4±12.9 and 36.2±11.2 years, respectively (p=0.09). In total, 100 (83%) patients and 78 (73%) controls were male (p=0.075). The mean indirect bilirubin levels were 1.44±0.66 mg/dL in the patient group and0.37±0.18 mg/dL in the control group. Based on the Beighton score, 23 patients (19.2%) in the patient group and 3 (2.8%) individualsin the control group had joint hypermobility. The difference between the groups was statistically significant (p