| Objective: Reduced serum bilirubin levels are negatively correlated with the development of type 2 diabetic nephropathy. Some studies have shown that serum bilirubin is closely correlated with hypertension, hyperlipidemia, coronary heart disease(CHD), cerebral infarction, insulin resistance, diabetic retinopathy, diabetic foot, diabetic peripheral neuropathy and even early diabetic nephropathy. Type 2 diabetic nephropathy is one of the chronic complications of type 2 diabetes, already became the important cause of end-stage renal disease in our country. Diabetic nephropathy is common in patients with type 2 diabetes mellitus. It has developed into an important cause of death in patients with type 2 diabetes mellitus. This subject mainly research whether the serum bilirubin is associated with type 2 diabetic nephropathy through the whole process.We measured and record all the research objects’ s height and weight.Weight divided by the square of height equals body mass index.We measure blood pressure of all the patients 3 times in the early morning,and finally record the the average blood pressure.All the people need to keep eating nothing for 10 hours after supper,they were phlebotomized in the early morning next day.We detected the concentration of AST, ALT, TC, TG, LDL, HDL- c- c, urea, creatinine, uric acid, total bilirubin, direct bilirubin, indirect bilirubin, blood sugar, etc by using fully automatic biochemical analyzer(Japan being future-proof, AU5400).We detected C peptide level by ria method.Hb A1 C is detected by using the method of high pressure liquid.Urine protein is also determined by ria method using DPC/Immulite- 1000 type chemiluminescence detector.Methods: There were 306 type 2 diabetic nephropathy patients and 200 healthy volunteers in this restrospective study. According to the Results of urine micro albumin in 24 hours, we pick out these type 2 diabetic nephropathy patients from hospitalized patients with type 2 diabetes in recent years.Then we calculate the glomerular filtration rate(e GFR) by using the chronic kidney disease(CKD)- EPI formula. According to the order from low to high, 306 type 2 diabetic nephropathy patients were divided into four groups, ranked healthy controls group 5.Results: The mean of serum total bilirubin concentrations in four type 2 diabetic nephropathy groups and the fifth healthy controls group are:(6.6±2.2)umol/L,(8.5±4.6)umol/L、(10.6±4.9)umol/L、(11.3±4.0)umol/L、(14.9±4.1)umol/L respectively. The difference between five groups have statistical significance except the difference between group 3 and group 4. The mean of serum direct bilirubin concentrations in five groups are:(2.3±1.0)umol/L、(3.1±1.7)umol/L、(3.7±1.3)umol/L、(3.8±2.1)umol/L、(4.7±1.4)umol/L respectively. Similar to the comparatation of serum total bilirubin, the difference between five groups have statistical significance except the difference between group 3 and group 4. The mean of serum indirect bilirubin concentrations in five groups are:(4.3±1.8)umol/L、(5.5±3.3)umol/L、(6.8±3.2)umol/L、(7.6±3.1)umol/L、(10.1±3.0)umol/L respectively. The difference between group 1 and group 2 has no statistical significance.the difference between group 3 and group 4 is as the same as the difference between group 1 and group 2. The difference between other groups have statistical significance. Pearson correlation analysis showed that serum bilirubin levels are positively correlated with e GFR, age, serum albumin. At the same time, serum bilirubin levels are negatively correlated with diabetes duration, weight, BMI, uric acid, urea, creatinine, TC, TG, LDL- c.Conclusions: Compared with healthy people, Type 2 diabetic nephropathy patients have lower bilirubin levels, and the bilirubin levels decrease as the e GFR levels reduce in patients with type 2 diabetic nephropathy. In type 2 diabetic nephropathy patients, serum bilirubin levels are negatively correlated with diabetes duration, weight, BMI, uric acid, urea, creatinine, TC, TG, LDL- c. The serum bilirubin levels decrease through the whole development process of type 2 diabetic nephropathy. The reduced serum bilirubin levels can be used as risk predictors of type 2 diabetic nephropathy. |
PDF Full Text Request