The changes and clinical significance of serum bilirubin in children with type 1 diabetes mellitus / 中华实用儿科临床杂志

ABSTRACT

Objective:To explore the changes and clinical significance of bilirubin in children with type 1 diabetes mellitus.Methods:A total of 142 inpatients diagnosed with type 1 diabetes mellitus in the Endocrinology and Genetics Metabolism Department of Shanxi Children′s Hospital from January 2015 to August 2019 were enrolled in the diabetes mellitus group of this study.These patients were subdivided into the newly diagnosed group (45 cases, who were newly diagnosed with type 1 diabetes mellitus) and the group with a longer course (97 cases, who were diagnosed with type 1 diabetes mellitus for over 1 year) according to the course of disease.Another 140 healthy children undergoing physical examination at the same time were treated as the control group.The levels of total, conjugated and unconjugated bilirubin between the control group and the diabetes mellitus group were analyzed statistically.The proportions of patients with the total bilirubin value>25.14 μmol/L in each group were calculated.The correlation of the levels of total and indirect bilirubin with the disease duration and glycated hemoglobin(HbA1C) in the diabetes mellitus group was analyzed by Pearson correlation. Results:(1) The levels of total, conjugated and unconjugated bilirubin in the diabetes mellitus group were (12.62±6.29) μmol/L, (2.46±1.27) μmol/L, and (10.15±5.18) μmol/L, respectively, which were all significantly higher than those in the control group [(10.36±3.36) μmol/L, (1.94±1.00) μmol/L, and (8.41±3.05) μmol/L], and the differences were all significant (all P<0.05). The proportion of patients with total bilirubin> 25.14 μmol/L (7.1%) in the diabetes mellitus group was significantly higher than that in the control group (0) ( P<0.05). (2) The HbA1C level of the group with a longer course [(8.93 ±1.78)%] was significantly lower than that of the newly diagnosed group [(10.94 ± 2.68)%], while the unconjugated bilirubin levels [(10.65±5.88) μmol/L] and the proportion of patients with total bilirubin> 25.14 μmol/L (10.30%) in the diabetes mellitus group were all significantly higher than those in the newly diagnosed group [(9.06 ± 3.00) μmol/L, 0] (all P < 0.05). (3) Pearson correlation analysis proved that the level of total bilirubin was negatively correlated with disease duration ( r =-0.218, P<0.05), but total bilirubin and unconjugated bilirubin levels were not correlated with HbA1C (all P> 0.05). Conclusions:Bilirubin increases in the early stage of onset and progression of type 1 diabetes mellitus in children.It is speculated that bilirubin may be one of the reference indicators of the antioxidant level in type 1 diabetes mellitus in the future.