PMID- 29238034
OWN - NLM
STAT- MEDLINE
DCOM- 20180806
LR  - 20221207
IS  - 1643-3750 (Electronic)
IS  - 1234-1010 (Print)
IS  - 1234-1010 (Linking)
VI  - 23
DP  - 2017 Dec 14
TI  - Inverse Relationship Between Serum Bilirubin Levels and Diabetic Foot in Chinese 
      Patients with Type 2 Diabetes Mellitus.
PG  - 5916-5923
AB  - BACKGROUND Several studies demonstrated that bilirubin, a potent endogenous 
      antioxidant, is a strong protective factor for many diabetic complications such 
      as nephropathy, retinopathy, neuropathy, and vasculopathy. The purpose of this 
      study was to assess the association between serum bilirubin levels and diabetic 
      foot (DF) in Chinese patients with type 2 diabetes mellitus (T2DM). MATERIAL AND 
      METHODS The present cross-sectional study of bilirubin levels in relation to DF 
      was conducted in 1,269 T2DM patients with (n=578) and without (n=691) DF. Blood 
      test results were obtained on hospital admission, including total bilirubin 
      (T-BIL), direct bilirubin (D-BIL), and indirect bilirubin (I-BIL). Data on Wagner 
      classification and amputation procedure in patients with DF were collected by 
      reviewing electronic medical records. Univariate or multivariate analysis were 
      performed to explore the association between bilirubin and DF. RESULTS Serum 
      I-BIL levels were shown to play a protective role regarding the presence and 
      severity of DF (OR=0.75, p=0.029 and OR=0.90, p=0.021, respectively). In 
      addition, in a comparison of the lowest and highest tertiles of serum bilirubin 
      concentration, the highest tertile of serum T-BIL (OR=0.51, p=0.011) and I-BIL 
      (OR=0.28, p<0.001) was significantly related with a lower Wagner grade of DF. 
      Patients with DF in the highest tertiles of T-BIL carried a significantly lower 
      risk of amputation events than those in the lowest tertiles (OR=0.47, p=0.025). 
      CONCLUSIONS The present study provided evidence that decreased serum bilirubin 
      levels were independently associated with the presence and severity of DF and 
      amputation events in patients with DF.
FAU - Chen, Jifan
AU  - Chen J
AD  - School of the First Clinical Medical Sciences, Wenzhou Medical University, 
      Wenzhou, Zhejiang, China (mainland).
FAU - Wang, Jian
AU  - Wang J
AD  - School of the First Clinical Medical Sciences, Wenzhou Medical University, 
      Wenzhou, Zhejiang, China (mainland).
FAU - Zhang, Xingxing
AU  - Zhang X
AD  - Department of Endocrinology and Metabolism, The First Affiliated Hospital of 
      Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).
FAU - Zhu, Hong
AU  - Zhu H
AD  - Department of Endocrinology and Metabolism, The First Affiliated Hospital of 
      Wenzhou Medical University, Wenzhou, Zhejiang, China (mainland).
LA  - eng
PT  - Journal Article
DEP - 20171214
PL  - United States
TA  - Med Sci Monit
JT  - Medical science monitor : international medical journal of experimental and 
      clinical research
JID - 9609063
RN  - RFM9X3LJ49 (Bilirubin)
SB  - IM
MH  - Aged
MH  - Asian People
MH  - Bilirubin/*analysis/blood
MH  - China
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/blood/complications
MH  - Diabetic Foot/blood/*metabolism
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Risk Factors
PMC - PMC5739530
COIS- Conflict of interests None.
EDAT- 2017/12/15 06:00
MHDA- 2018/08/07 06:00
PMCR- 2017/12/14
CRDT- 2017/12/15 06:00
PHST- 2017/12/15 06:00 [entrez]
PHST- 2017/12/15 06:00 [pubmed]
PHST- 2018/08/07 06:00 [medline]
PHST- 2017/12/14 00:00 [pmc-release]
AID - 907248 [pii]
AID - 10.12659/msm.907248 [doi]
PST - epublish
SO  - Med Sci Monit. 2017 Dec 14;23:5916-5923. doi: 10.12659/msm.907248.