Association between serum bilirubin levels and decline in estimated glomerular filtration rate among patients with type 2 diabetes

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• 作者：Jing Wang^a ; Yaru Li^a ; Xu Han^a ; Hua Hu^a ; Fei Wang^a ; Caizheng Yu^a ; Xiulou Li^b ; Kun Yang^b ; Jing Yuan^a ; Ping Yao^a ; Xiaoping Miao^c ; Sheng Wei^c ; Youjie Wang^a ; Weihong Chen^a ; Yuan Liang^a ; Xiaomin Zhang^a ; Huan Guo^a ; An Pan^c ; Handong Yang^b ; Tangchun Wu^a ; Meian He^a ; ^{hemeian@hotmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Bilirubin ; Type 2 diabetes ; Kidney disease ; Cohort study ; Chinese
• 刊名：Journal of Diabetes and its Complications
• 出版年：2016
• 出版时间：September-October 2016
• 年：2016
• 卷：30
• 期：7
• 页码：1255-1260
• 全文大小：370 K

文摘

Studies indicate that elevated serum total bilirubin (TBil) levels are associated with lower risk of diabetic kidney disease (DKD). Few studies examined the associations of direct bilirubin (DBil) and indirect bilirubin (IBil) with the development of DKD.

Methods

Type 2 diabetes patients (n = 2,958) with estimated glomerular filtration (eGFR) ≥ 60 ml min^− 1 1.73 m^− 2 from the Dongfeng–Tongji cohort were selected and followed up for 5 years. Development of DKD was defined as decline in eGFR ≥ 30% during follow-up. Generalize linear model was used to assess the associations of bilirubin levels with DKD development.

Results

Compared with those in the first tertile of serum TBil, the relative risks (RRs) and 95% confidence intervals (CIs) of incident eGFR decline for tertile 2 to 3 were 0.83 (0.64–1.09) and 0.74 (0.56–0.98), P_trend = 0.04. The counterpart RRs (95% CIs) in IBil were 0.74 (0.57–0.97) and 0.75 (0.57–0.98), P_trend = 0.04. No significant associations were observed in DBil. Moreover, TBil and IBil interacted with smoking, the bilirubin-DKD associations were evident in ever smokers.

Conclusions

Our findings suggest that elevation of serum TBil or IBil levels are independent protective factors for development of DKD, particularly in smokers.