Department of Geriatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Diabetes Res Clin Pract. 2010 Apr;88(1):103-10. doi: 10.1016/j.diabres.2009.12.022. Epub 2010 Jan 18.
The aim of this study was to examine the association of serum bilirubin, an endogenous antioxidant, with serum high sensitivity C-reactive protein (hs-CRP) level, HbA(1c), and the prevalence of type 2 diabetes in middle-aged and elderly Japanese men and women (n=12,400).
Analysis of covariance and logistic regression analysis were used to estimate geometric means of hs-CRP and HbA(1c) and odds ratios of prevalent diabetes according to bilirubin concentrations, respectively, with statistical adjustment for behavioral factors and liver enzymes.
Geometric means of hs-CRP and HbA(1c) were progressively lower with increasing concentrations of serum bilirubin in men and women each. An inverse association between serum bilirubin and HbA(1c) was slightly attenuated after adjustment for hs-CRP, but still remained highly significant (trend P=0.0004 in men and trend P=10(-5) in women). Multivariate-adjusted odds ratios of prevalent diabetes for the lowest to highest quintiles of serum total bilirubin were 1.00, 1.00, 0.73, 0.80, and 0.73 (trend P=0.002), without adjustment for hs-CRP, and 1.00, 1.04, 0.76, 0.86, and 0.79 (trend P=0.01), with adjustment for hs-CRP.
Higher concentrations of serum bilirubin probably confer protection against the development of type 2 diabetes.
本研究旨在探讨内源性抗氧化剂血清胆红素与血清高敏 C 反应蛋白（hs-CRP）水平、HbA(1c)及 2 型糖尿病患病率的关系。
采用协方差分析和逻辑回归分析，分别估计胆红素浓度与 hs-CRP 和 HbA(1c)的几何均数及糖尿病患病率的比值比，同时对行为因素和肝酶进行统计学调整。
男性和女性血清胆红素浓度逐渐升高时，hs-CRP 和 HbA(1c)的几何均数逐渐降低。在调整 hs-CRP 后，血清胆红素与 HbA(1c)之间的负相关关系略有减弱，但仍具有高度显著性（男性趋势 P=0.0004，女性趋势 P=10(-5)）。在未调整 hs-CRP 时，血清总胆红素最低至最高五分位数的 2 型糖尿病患病率的多变量调整比值比分别为 1.00、1.00、0.73、0.80 和 0.73（趋势 P=0.002），而在调整 hs-CRP 后分别为 1.00、1.04、0.76、0.86 和 0.79（趋势 P=0.01）。
血清胆红素浓度升高可能对 2 型糖尿病的发生具有保护作用。
