血清胆红素水平与台湾 2 型糖尿病患者白蛋白尿进展的关系。
Association between serum bilirubin levels and progression of albuminuria in Taiwanese with type 2 diabetes mellitus.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
出版信息
Biomed J. 2021 Apr;44(2):201-208. doi: 10.1016/j.bj.2019.12.004. Epub 2021 May 5.
BACKGROUND
To investigate the association between serum bilirubin (BIL) levels and the progression of albuminuria in type 2 diabetic Taiwanese.
METHODS
Longitudinal data from January 2001 to June 2015 were retrospectively reviewed from Chang Gung Memorial Hospital in Taiwan. A total of 2877 type 2 diabetic patients with normal total BIL levels were divided into 4 groups according to BIL, with the highest BIL in the fourth group. The urinary albumin/creatinine ratio (UACR) trend and progression, as well as other laboratory measurements, were evaluated among the four groups. The cumulative incidence and Cox proportional hazard model analysis were performed to examine the relationship between BIL and the risk of albuminuria progression (AUPr).
RESULTS
The mean duration of follow-up was 1.5 years (±1.37 years). The mean patient age, glycosylated hemoglobin level, and duration of diabetes were 62.52 years, 7.9%, and 3.94 years, respectively. A significant correlation was observed between BIL and both the UACR at baseline (P < 0.001) and the cumulative incidence of AUPr (log-rank test, P = 0.031). Hazard ratio (HR) analysis revealed that patients in the fourth BIL quartile had the lowest HR risk of AUPr among the four groups (adjusted HR = 0.70; 95% Confidence Interval = 0.56-0.89, P < 0.05).
CONCLUSIONS
Higher serum BIL levels are associated with a lower risk of AUPr in type 2 diabetes patients in Taiwan.
背景
探讨血清胆红素（BIL）水平与台湾 2 型糖尿病患者白蛋白尿进展的关系。
方法
回顾性分析 2001 年 1 月至 2015 年 6 月来自台湾长庚纪念医院的纵向数据。将 2877 例总胆红素水平正常的 2 型糖尿病患者根据 BIL 分为 4 组，第 4 组 BIL 最高。评估 4 组间尿白蛋白/肌酐比值（UACR）趋势和进展以及其他实验室测量值。采用累积发病率和 Cox 比例风险模型分析探讨 BIL 与白蛋白尿进展（AUPr）风险之间的关系。
结果
平均随访时间为 1.5 年（±1.37 年）。患者平均年龄、糖化血红蛋白水平和糖尿病病程分别为 62.52 岁、7.9%和 3.94 年。BIL 与 UACR 基线（P<0.001）和 AUPr 累积发生率（对数秩检验，P=0.031）均呈显著相关。风险比（HR）分析显示，4 组中 BIL 第 4 四分位组的 AUPr 发生风险最低（调整 HR=0.70；95%置信区间为 0.56-0.89，P<0.05）。
结论
血清胆红素水平较高与台湾 2 型糖尿病患者 AUPr 风险降低相关。
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