Association of Circulating Bilirubin Levels with Newly Diagnosed Nonproliferative Diabetic Retinopathy and Its Related Risk Factors： A Case-control Study
10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2022.0119
- VernacularTitle:循环胆红素水平与新诊断非增殖期糖尿病视网膜病变及其危险因素相关性的病例对照研究
- Author:
Yuan-hua LIU
1
;
Xue-yan LI
1
;
Lei SU
1
;
Jia-lin HE
1
;
Xiu-wen GENG
1
;
Jia-jun JI
1
;
Song TANG
2
;
Li-na ZHAO
1
Author Information
1. Department of Nutrition， School of Public Health， Sun Yat-sen University // Guangdong Provincial Key Laboratory of Food， Nutrition and Health， Guangzhou 510080， China
2. Shenzhen Eye Hospital // Shenzhen Key Laboratory of Ophthalmology， Shenzhen 518000， China
- Publication Type:Journal Article
- Keywords:
nonproliferative diabetic retinopathy;
total bilirubin;
conjugated bilirubin;
unconjugated bilirubin;
glycated hemoglobin
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2022;43(1):152-160
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveThis study aimed to assess the circulating bilirubin profile ［total bilirubin （TBIL）， conjugated bilirubin （DBIL）， unconjugated bilirubin （IBIL）］ and their associations with nonproliferative diabetic retinopathy （NPDR）. MethodsA case-control study which enrolled 312 type 2 diabetic mellitus （T2DM） patients （78 newly diagnosed NPDR 1：3 matched with 234 T2DM without diabetic retinopathy） was conducted. Diabetic retinopathy was screened by artificial intelligence fundus camera and further confirmed by the ophthalmologist， and demographic and clinical information were collected. Serum bilirubin and related biochemical indicators were assessed. ResultsPatients with NPDR had significantly lower serum TBIL， DBIL and IBIL concentrations （P values were 0.003， 0.001 and 0.006）， which were not associated with glycated hemoglobin （HbA1c） concentration （all P values >0.05）. The association persisted after adjustment for traditional risk factors including gender， diabetes duration， HbA1c and systolic blood pressure. Moreover， low IBIL had a higher risk of NPDR with odds ratio （OR） 95%CI of 3.44 （1.04， 11.38） in well glycemic controlled T2DM patients （HbA1c ≤7%） or of 2.53 （1.10， 5.82） in T2DM patients without microalbuminuria ［urine albumin creatine ratio （UACR） ≤30mg/g］； low DBIL had a higher risk of NPDR with OR 95%CI of 2.05 （1.09， 3.86） in poor glycemic controlled T2DM patients （HbA1c>7%） or of 2.40 （1.14， 5.02） in T2DM patients with microalbuminuria （UACR >30mg/g）. ConclusionOur results suggested that circulating bilirubin level is inversely and independently associated with NPDR which might be an early clinical biomarker for predicting and preventing diabetic retinopathy.
