Reply to comment: Serum bilirubin concentrations, type 2 diabetes, and incident coronary heart disease
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We appreciate the comments by Dr. Kawada on our article , which recommended to conduct comprehensive analysis by including renal function and serum uric acid concentration in the multivariate model to assess the associations of serum bilirubin levels and coronary heart disease (CHD) risk among type 2 diabetes (T2D) cases . As indicated in Table 1, further introduction of estimated glomerular filtration (eGFR) and serum uric acid into the multivariate model did not materially change the association of total bilirubin, direct bilirubin, and indirect bilirubin with CHD risk. The eGFR level was related to the incident CHD risk among T2D cases with marginally statistical significance (hazard ratio: 1.00; 95% confidence interval 0.99–1.00; P = 0.033), while serum uric acid concentration was not (hazard ratio: 1.00; 95% confidence interval 0.92–1.08, P = 0.94).
Baseline bilirubin levels and the risk of incident coronary heart disease in type 2 diabetes (n = 2918)
KeywordsBilirubin Type 2 diabetes Coronary heart disease Renal function Uric acid
This work was funded by the grant from the National Natural Science Foundation (grant NSFC- 81872698, 81522040 and 81473051); the Program for HUST Academic Frontier Youth Team; National Key R&D Program of China (2017YFC0907501); the 111 Project (No. B12004); Innovative Research Team in University of Ministry of Education of China (No. IRT1246); China Medical Board (No. 12–113).The Natural Science Foundation of Hubei Province of China (2017CFC856) and Faculty Development Grant from Hubei University of Medicine (2016QDJZR12).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict.
Human and animals rights
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.
Informed consent was obtained from all patients for being included in the study.