Sekioka Risa, Tanaka Masami, Nishimura Takeshi, Itoh Hiroshi
Division of Endocrinology, Metabolism and Nephrology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
J Diabetes Complications. 2015 Mar;29(2):218-21. doi: 10.1016/j.jdiacomp.2014.12.002. Epub 2014 Dec 5.
Serum bilirubin concentration is associated with diabetic retinopathy in patients with type 2 diabetes. This study investigated the relationships between serum bilirubin concentration and the severity of diabetic retinopathy. In addition, the importance of bilirubin was compared with factors that were previously shown to be associated with the incidence of diabetic retinopathy.
A total of 674 patients with type 2 diabetes were investigated in this cross-sectional study. Serum total bilirubin concentration was compared between patients with and without diabetic retinopathy, and according to the severity of retinopathy. Univariate and multivariate analyses were performed to evaluate the association of retinopathy with total bilirubin concentration, duration of diabetes, body mass index, systolic blood pressure, and haemoglobin A1c.
Serum total bilirubin concentration was significantly lower in patients with retinopathy than in those without. Patients with severer retinopathy showed lower total bilirubin concentration, longer diabetes duration, and higher systolic blood pressure. These three parameters were independent explanatory factors for diabetic retinopathy.
Total bilirubin concentration is lower in patients with type 2 diabetes complicated with severer retinopathy. Thus, bilirubin might protect against retinopathy in patients with type 2 diabetes.
血清胆红素浓度与2型糖尿病患者的糖尿病视网膜病变相关。本研究调查了血清胆红素浓度与糖尿病视网膜病变严重程度之间的关系。此外，还将胆红素的重要性与先前显示与糖尿病视网膜病变发生率相关的因素进行了比较。
在这项横断面研究中，共调查了674例2型糖尿病患者。比较了有和没有糖尿病视网膜病变的患者之间以及根据视网膜病变的严重程度的血清总胆红素浓度。进行单因素和多因素分析以评估视网膜病变与总胆红素浓度、糖尿病病程、体重指数、收缩压和糖化血红蛋白之间的关联。
有视网膜病变的患者血清总胆红素浓度显著低于没有视网膜病变的患者。视网膜病变较严重的患者总胆红素浓度较低、糖尿病病程较长且收缩压较高。这三个参数是糖尿病视网膜病变的独立解释因素。
2型糖尿病合并较严重视网膜病变的患者总胆红素浓度较低。因此，胆红素可能对2型糖尿病患者的视网膜病变具有保护作用。
