Relationship between serum total bilirubin and diabetic retinopathy in type 2 diabetes mellitus / 中国医师杂志

ABSTRACT

Objective:To investigate the relationship between serum total bilirubin and diabetic retinopathy (DR) in type 2 diabetes mellitus.Methods:A retrospective analysis was performed on 1676 patients with type 2 diabetes who were admitted to the Department of Endocrinology, the Third Affiliated Hospital of Anhui Medical University (Hefei First People′s Hospital) from January 2010 to December 2016. According to the fundus examination results, they were divided into diabetic retinopathy group (DR group) and the non-diabetic retinopathy group (NDR group). The clinical data of the two groups were compared and divided into Q1, Q2 and Q3 groups according to the total bilirubin trigrams to analyze the correlation between the serum total bilirubin level and the occurrence of DR.Results:The comparison between the two groups showed that the serum total bilirubin, direct bilirubin and indirect bilirubin of DR group were lower than those of NDR group ( P<0.05), and the age, disease course, systolic blood pressure, urea nitrogen and blood uric acid of DR group were higher than that of NDR group ( P<0.05). When the risk factors between the two groups were included in the binary logistic regression equation, it was found that serum total bilirubin was protective factor of DR( OR 0.922, 95% CI 0.893-0.952), and disease course, systolic blood pressure and urea nitrogen were independent risk factors of DR. When the serum total bilirubin level was further divided into the third quadrant, the OR value of diabetic retinopathy in the third quadrant was 0.455 (95% CI 0.328-0.629) compared with the first quadrant, after adjusting for confounding factors. Conclusions:Serum total bilirubin is the protective factor of DR and it may be an early clinical marker to predict the occurrence of DR. For patients with low serum bilirubin, the levels of urea nitrogen and systolic blood pressure should be closely monitored, which is of great significance for the prevention and treatment of DR.