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Serum bilirubin levels are negatively associated with diabetic retinopathy in patients with type 1 diabetes and normal renal function

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Abstract

Introduction

Previous studies suggested that total serum bilirubin levels are negatively associated with diabetic retinopathy (DR) and nephropathy in patients with diabetes mellitus. The objective of this study was to explore the relationship between serum total bilirubin levels and prevalence of DR in patients with type 1 diabetes (T1DM) and normal renal function.

Methods

Study included 163 T1DM with normal renal function (urinary albumin excretion rate <30 mg/24 h, estimated glomerular filtration rate (eGFR) >60 ml min−11.73 m−2). Photo-documented retinopathy status was made according to the EURODIAB protocol.

Results

Patients with DR were older (49 vs 42 years, p = 0.001), had higher systolic blood pressure (130 vs 120 mmHg, p = 0.001), triglycerides (0.89 vs 0.77 mmol/L, p = 0.01), and lower serum total bilirubin (12 vs 15 U/L, p = 0.02) and eGFR (100 vs 106 ml min−11.73 m−2, p = 0.03). In multivariate logistic regression analysis, only total serum bilirubin was significantly associated with risk of DR in our subjects (OR 0.88, CI 0.81–0.96, p = 0.006).

Conclusion

These data suggest that serum total bilirubin levels are independently negatively associated with DR in T1DM with normal renal function. Prospective studies are needed to confirm whether lower serum total bilirubin has predictive value for the development of DR in T1DM with normal renal function.

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Funding

This study was funded by the Croatian Science Foundation (Grant No. 7459).

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Authors and Affiliations

  1. Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Dugi dol 4a, Zagreb, Croatia

    Tomislav Bulum, Martina Tomić & Lea Duvnjak

  2. Medical School, University of Zagreb, Zagreb, Croatia

    Tomislav Bulum & Lea Duvnjak

Authors
  1. Tomislav Bulum
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  2. Martina Tomić
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  3. Lea Duvnjak
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Correspondence to Tomislav Bulum.

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The authors disclose no conflict of interest.

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All procedures were in accordance with the ethical standards of the institutional committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Bulum, T., Tomić, M. & Duvnjak, L. Serum bilirubin levels are negatively associated with diabetic retinopathy in patients with type 1 diabetes and normal renal function. Int Ophthalmol 38, 1095–1101 (2018). https://doi.org/10.1007/s10792-017-0565-8

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  • DOI: https://doi.org/10.1007/s10792-017-0565-8

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