Association Of Serum Total Bilirubin Level With Diabetic Retinopathy In Type 2 Diabetes Mellitus (original) (raw)
Related papers
2020
Aims: To investigate the association between Total Bilirubin levels and Diabetic Retinopathy in patients with Type 2 Diabetes Mellitus. Material and Methods: In this prospective, randomized study, a total of 60 diabetic patients presenting to Subharti Hospital, Meerut were divided in following categories. 1) Mild Non-Proliferative Diabetic Retinopathy (NPDR). 2) Moderate NPDR. 3) Severe NPDR. 4) Proliferative Diabetic Retinopathy (PDR) 5) No DR. The eye with worse retinopathy was chosen for inclusion in the study examinations. If both eyes had equal retinopathy, the right eye was assigned to the study. Cases were followed up at 1 week, 1 month and 6 months after first visit. Serum total bilirubin levels were measured at each follow-up visit. Observation and Result: On correlation analysis, the two variables Diabetic retinopathy Fundus grading and Total Serum bilirubin levels are inversely and significantly correlated at baseline, 1 week, 1 month and 6 months. Conclusion: Serum bilir...
Association of bilirubin and malondialdehyde levels with retinopathy in type 2 diabetes mellitus
Indian Journal of Endocrinology and Metabolism, 2015
Introduction: Bilirubin as an antioxidant and malondialdehyde (MDA) as an oxidant have been shown to be associated with various complications of type 2 diabetes mellitus (DM). Aims and Objectives: The aim was to measure the levels of serum bilirubin and MDA in type 2 DM patients with and without diabetic retinopathy (DR) and to correlate them with severity of DR. Materials and Methods: A total number of 120 subjects out of which 40 were controls without type 2 DM and the rest 80 were type 2 DM patients were included in the study. Of those 80 diabetics, 44 patients did not have DR and 36 patients had DR. Results: The total bilirubin, direct bilirubin, indirect bilirubin were higher in controls as compared to cases (P = 0.017, 0.033, 0.024). Serum MDA levels were found to be higher in diabetics as compared to controls (P = 0.00). The values of all the three parameters, that is, total bilirubin, direct bilirubin and indirect bilirubin were lower in patients with retinopathy as compared to those without retinopathic changes (P = 0.00, 0.020, and 0.007). Subjects were assigned to quartiles based on serum total bilirubin concentration. The prevalence of DR was significantly lower among persons with the highest bilirubin quartile compared to those with the lowest quartile. The severity of DR was inversely proportional to the total bilirubin levels (P = 0.001). The multiple logistic regression analysis showed total bilirubin to be associated with prevalence of DR (P = 0.035). Conclusions: The levels of total bilirubin were significantly lower in patients with DR and also in the late stages of retinopathy as compared to those without retinopathy and in controls but MDA levels did not show any association with DR.
ABSTRACTAims/IntroductionPrevious reports have indicated that serum bilirubin levels may be associated with diabetic retinopathy. However, the detailed mechanism is not fully understood. In this study, we evaluated the relationship between the severity of diabetic retinopathy and various factors including bilirubin levels and factors influencing bilirubin metabolism.MethodsThe study participants consisted of 94 consecutive patients with diabetes mellitus admitted to Kyushu University Hospital from April 2011 to July 2012. The patients were classified into three groups: no retinopathy (NDR), simple retinopathy (SDR), and pre-proliferative or proliferative retinopathy (PDR). The relationship between the severity of retinopathy and various factors was evaluated using univariate and logistic regression analyses. In addition, multivariate regression analysis was performed to evaluate the significant determinants for bilirubin levels.ResultsIn univariate analysis, a significant difference...
Serum Bilirubin is Significantly Associated with Hba1c in Type 2 Diabetic Subjects
Endocrinology&Metabolism International Journal
Diabetes mellitusis a group of metabolic diseases characterized by increase blood glucose level defects in insulin secretion and insulin action. Bilirubin has anti-inflammatory, antiapoptotic and antioxidant properties. As an antioxidant, it has been shown to suppress the oxidation of lipids and lipoproteins; especially LDL-cholesterol. The present study was conducted to assess the relationship between serum bilirubin levels with insulin resistance and other potential risk factors of diabetes in type 2diabetic subjects. This cross sectional study was conducted on 200 type 2diabetic subjects who attended Amin Hayat Memorial Hospital in Lahore. Patients with age group 27-64years were included in the study. Out of which 90 were males and 110 were females. Different demographic and biochemical parameters as age, BMI, WHR, Blood pressure, personal history and socioeconomic status were recorded while fasting blood glucose and random blood glucose. HbA1c, lipid profile and serum bilirubin levels, serum insulin by chemistry analyzer and ELISA. HOMA IR was calculated. The level of bilirubin showed negative significant association with fasting blood glucose, HbA1c and cholesterol, LDL-cholesterol and triglycerides while non significant association was observed with BMI (Kg/m²), WHR, B.P
BackgroundIn type 2 Diabetes Mellitus (T2DM) chronic hyperglycemia leads to multi-organ damage. It is a chronic low-grade inflammation resulting in reduced antioxidants leading to many complications. Hyperglycemia causes glycation of serum proteins forming advanced glycation end products (AGEs). HBA1c is an AGE of haemoglobin. Bilirubin considered a waste product of the heme catabolic pathway, has proven to be a natural antioxidant associated with a lower prevalence of oxidative stress-mediated diseases. Bilirubin prevents glycation of proteins providing benefit in T2DM. General objective - To evaluate the association of serum bilirubin levels with HBA1c, FBS, PPBS in diabetes patients. Specific objectives - 1) To compare the serum bilirubin levels in diabetes patients with good and poor control. 2) To evaluate the association of HbA1c with FBS, PPBS and age in controlled and uncontrolled diabetes mellitusMethodology -A retrospective analytical study done at the department of Haemat...
Sohag Medical Journal
Background: One of the major complications of type 2 diabetes is diabetic nephropathy (DN). Nephropathy develops in ~20-40% of patients with diabetes and is the single leading cause of end-stage renal disease (ESRD) around the world.(1) Oxidative stress has been considered to be an important pathogenic factor in the development of diabetic vascular complications, including nephropathy. Bilirubin(BIL) has been recognized as an endogenous antioxidant. Objective: The objective of this study is to detect the relationship between serum bilirubin concentrations and diabetic nephropathy in patients with type 2 diabetes mellitus. PATIENTS & METHODS:The study included 92 patient with type 2 diabetes mellitus who visit Sohag University Hospital ,All patients in this study were subjected to full history taking, complete physical examination, and laboratory investigations including urine analysis, albumin creatinine ratio, renal and liver function tests. Patients with T2DM were recruited and bilirubin concentrations were compared between patients with or without diabetic nephropathy. DN was diagnosed according to KDOQI Clinical Practice Guidelines and Clinical Practice Recommendations for Diabetes and Chronic Kidney Disease .(7) Patients were classified according to stage of nephropathy (8): Conclusions Serum bilirubin concentration correlated negatively with stage of diabetic nephropathy, which suggests that bilirubin has a potential role for protection of diabetic nephropathy.
The Korean journal of internal medicine, 2017
We evaluated whether serum bilirubin levels can predict the development of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM). This was a retrospective observational longitudinal study of patients presenting at the Pusan National University Hospital. A total of 349 patients with T2DM and preserved kidney function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2) were enrolled. The main outcome was the development of CKD stage 3 or greater. The patients were divided into four groups according to the quartiles of the total serum bilirubin levels at baseline. The group with the lowest range of total serum bilirubin level (Q1) showed the highest cumulative incidence of CKD stage 3 or greater than that of the other lower quartiles (Q1 vs. Q4; hazard ratio [HR], 6.75; 95% confidence interval [CI], 1.54 to 29.47; p = 0.011). In multivariate analysis, the risk of developing CKD stage 3 or greater was higher in the second lowest quartile of the serum bilir...
Total serum bilirubin does not affect vascular reactivity in patients with diabetes
Vascular Medicine, 2009
Bilirubin may have a major role in the prevention of cardiovascular disease based on recent data regarding its anti-oxidant properties. We determined the relationship between total serum bilirubin and vascular reactivity in a large cohort of individuals with diabetes, a disease associated with known oxidant stress. We studied 302 individuals: 52 controls, 37 with type 1 diabetes, 213 with type 2 diabetes. Highresolution ultrasound was used to measure flow-mediated dilation (FMD; endotheliumdependent) and nitroglycerin-induced dilation (NID, endothelium-independent) of the brachial artery. Laser Doppler perfusion imaging was used to measure microvascular reactivity in the forearm skin before and after iontophoresis of acetylcholine (endothelium-dependent) and sodium nitroprusside (endothelium-independent). Bilirubin levels were higher in the type 2 diabetes group (0.71 ± 0.34 mg/dl) compared to controls (0.56 ± 0.26 mg/dl, p < 0.0001). A weak inverse correlation was observed between bilirubin and FMD (r = -0.125, p = 0.032) and skin endothelium-dependent vasodilation (r = -0.157, p = 0.019). In multivariate analyses, however, these correlations were not statistically significant. There is no association between bilirubin levels and vascular reactivity in the macro-and microcirculation of individuals with diabetes. Bilirubin, therefore, does not correlate with predictors of cardiovascular risk in the diabetic population.
PLOS ONE
Objective Previous reports have demonstrated the association of serum bilirubin levels with the progression of diabetic nephropathy. The objective of this study is to assess the association of basal bilirubin levels with progressive renal decline (PRD) and end-stage kidney disease (ESKD). Methods A total of 298 patients with diabetes who visited Kyushu University Hospital (Japan) were recruited and followed up for 10 years. PRD was defined as a negative change in estimated glomerular filtration ratio (eGFR) >3.7%/year, 2.5th percentile. Logistic regression analysis was performed to evaluate the association of total bilirubin levels with PRD and its cut-off point was determined by receiver operating characteristic (ROC) analysis. Kaplan-Meier method and Cox hazard regression analysis were used to evaluate the predictive ability of its cut-off point for ESKD. Results Logistic regression model showed that total bilirubin levels were significantly associated with PRD, and ROC analysi...
Journal of Diabetes Investigation, 2021
Aims/Introduction: Diagnosis of diabetic peripheral neuropathy (DPN) depends on subjective findings, certain investigations for DPN risks have not been performed enough. Bilirubin protects against vascular complications by reducing oxidative stress in diabetes, but is not fully tested for DPN. This study aimed to evaluate sural nerve conduction impairments (SNCI) as an objective DPN marker and the contribution of bilirubin to SNCI. Materials and methods: Using DPN-Check â , SNCI was defined as a decline of amplitude potential or conduction velocity below the normal limit in 150 inpatients with diabetes. The correlations between SNCI and conventional DPN diagnosis criteria, the incidence of diabetic retinopathy/nephropathy, biomarkers for atherosclerosis, cardiac function by ultrasonic cardiogram, and bilirubin were statistically tested, followed by the comparison of logistic regression models for SNCI to find confounders with bilirubin. Results: The incidence of SNCI was 72.0%. The sensitivity and specificity of SNCI for DPN prediagnosis by simplified criteria were 54.6 and 90.5%, respectively, and similarly corresponded with diabetic retinopathy and nephropathy (sensitivity 57.4 and 50.0%, respectively). SNCI significantly related to diabetes duration, declined estimated glomerular filtration rate, albuminuria and total bilirubin. SNCI incidence was attenuated in the higher bilirubin tertiles (89.8/65.3/54.8%, P < 0.001). Bilirubin was an independent inverse risk factor for SNCI, even after adjustment by known risk factors for DPN and markers for microvascular complications. Conclusions: SNCI is a comprehensive marker for diabetic complications. We first showed the independent inverse relationship between bilirubin and SNCI through the independent pathway with other complications, provably reducing oxidative stress, as previously reported.