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

被引:21
作者
Wang, Jing [1 ,2 ]
Li, Yaru [1 ,2 ]
Han, Xu [1 ,2 ]
Hu, Hua [1 ,2 ]
Wang, Fei [1 ,2 ]
Yu, Caizheng [1 ,2 ]
Li, Xiulou [3 ,4 ]
Yang, Kun [3 ,4 ]
Yuan, Jing [1 ,2 ]
Yao, Ping [1 ,2 ]
Miao, Xiaoping [5 ]
Wei, Sheng [5 ]
Wang, Youjie [1 ,2 ]
Chen, Weihong [1 ,2 ]
Liang, Yuan [1 ,2 ]
Zhang, Xiaomin [1 ,2 ]
Guo, Huan [1 ,2 ]
Pan, An [5 ]
Yang, Handong [3 ,4 ]
Wu, Tangchun [1 ,2 ]
He, Meian [1 ,2 ]
机构
[1] Huazhong Univ Sci & Technol, Dept Occupat & Environm Hlth, Tongji Med Coll, Sch Publ Hlth, 13 Hangkong Rd, Wuhan 430030, Hubei, Peoples R China
[2] Huazhong Univ Sci & Technol, State Key Lab Environm Hlth Incubating, Tongji Med Coll, Sch Publ Hlth, 13 Hangkong Rd, Wuhan 430030, Hubei, Peoples R China
[3] Dongfeng Motor Corp, Dongfeng Cent Hosp, Shiyan, Hubei, Peoples R China
[4] Hubei Univ Med, Shiyan, Hubei, Peoples R China
[5] Huazhong Univ Sci & Technol, Dept Epidemiol & Biostat, Sch Publ Hlth, Tongji Med Coll, Wuhan, Hubei, Peoples R China
关键词
Bilirubin; Type; 2; diabetes; Kidney disease; Cohort study; Chinese; CHRONIC KIDNEY-DISEASE; ALBUMIN-BOUND BILIRUBIN; LOW-DENSITY-LIPOPROTEIN; CARDIOVASCULAR-DISEASE; OXIDATIVE STRESS; RISK-FACTORS; ANTIOXIDANT; COMPLICATIONS; NEPHROPATHY; SMOKING;
D O I
10.1016/j.jdiacomp.2016.05.013
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: 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. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:1255 / 1260
页数:6
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