# Integrative Role of Bilirubin on Obesity

> **NIH NIH R01** · UNIVERSITY OF MISSISSIPPI MED CTR · 2021 · $497,217

## Abstract

Abstract
Obesity is the leading cause of non-alcoholic fatty liver disease (NAFLD) and type II diabetes. Both of these
conditions contribute to the morbidity and mortality rates of obesity. Large population studies have
demonstrated a negative correlation between serum bilirubin levels and the development of NAFLD and type II
diabetes. Despite these correlative studies, the mechanism by which bilirubin protects against NAFLD and type
II diabetes is not known. We have exciting data demonstrating for the first time that bilirubin is also a signaling
molecule capable of signaling through the nuclear hormone receptors such as peroxisome proliferator-
activated receptor (PPAR) In addition, bilirubin can also inactivate glycogen synthase kinase-3 (GSK3) to
increase PPAR target genes such as fibroblast growth factor 21 (FGF21); however, the specific role of
GSK3 inactivation/PPAR activation to the anti-steatotic and anti-diabetic actions of moderate
hyperbilirubinemia is not known. Biliverdin reductase (BVR) is the enzyme responsible for the reduction of
biliverdin to bilirubin. It can generate bilirubin that is found in the plasma as well as bilirubin generated inside
the cell. The goal of this proposal is to test the central hypothesis that bilirubin and BVRA protect against
obesity induced hepatic steatosis and insulin resistance via activation of the PPARsignaling axis. Aim 1 of
the proposal will test the hypothesis that chronic moderate hyperbilirubinemia resulting from bilirubin treatment
or antagonism of hepatic UGT1A1 can reverse dietary obesity induced hepatic steatosis and hepatic insulin
resistance. Aim 2 of the proposal will test the hypothesis that moderate hyperbilirubinemia reverses hepatic
steatosis and insulin resistance via activation of PPAR. Aim 3 of the proposal will test the hypothesis that that
specific loss of hepatic bilirubin generation enhances hepatic steatosis and insulin resistance through a
GSK3mediated pathway that decreases PPAR activity. Findings of the studies outlined in the proposal will
have profound implications on the development of moderate hyperbilirubinemia as a novel therapy for the
treatment of obesity induced NAFLD and insulin resistance. These studies will also determine the novel role of
bilirubin as a nuclear hormone receptor signaling molecule and the role of this mechanism in the protection
against obesity induced NAFLD and insulin resistance.

## Key facts

- **NIH application ID:** 10129955
- **Project number:** 5R01DK121748-02
- **Recipient organization:** UNIVERSITY OF MISSISSIPPI MED CTR
- **Principal Investigator:** DAVID E STEC
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $497,217
- **Award type:** 5
- **Project period:** 2020-04-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10129955

## Citation

> US National Institutes of Health, RePORTER application 10129955, Integrative Role of Bilirubin on Obesity (5R01DK121748-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10129955. Licensed CC0.

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