title: Serum total bilirubin levels and prevalence of diabetic retinopathy in a Chinese population.
abstract: BACKGROUND
  Patients with type 2 diabetes (T2D) are at a high risk of developing microvascular complications, such as diabetic retinopathy (DR). Previous studies have shown that low serum bilirubin concentrations in T2D patients may increase the risk of diabetic complications. Thus, the aim of the present was to investigate the association between the prevalence of DR and serum concentrations of total bilirubin in a Chinese population.
  
  
  METHODS
  The present study was a population-based cross-sectional study on 1761 T2D patients aged ≥40 years from the Jiading district of Shanghai, China. Fundus photographs were taken to confirm the presence and severity of DR. Subjects were assigned to quartiles based on serum total bilirubin concentrations (Quartile (Q) 1 <0.60 mg/dL; Q2 0.60-0.76 mg/dL; Q3 0.77-0.99 mg/dL; Q4 >0.99 mg/dL). Logistic regression models were used to explore the association between bilirubin concentrations and the prevalence of DR.
  
  
  RESULTS
  The prevalence of DR in the entire study population was 9.6%. The prevalence of DR was significantly lower in Q4 compared with the other three quartiles (Ptrend  = 0.004). After adjustment for multiple confounding factors, T2D patients in Q4 (i.e. serum bilirubin >0.99 mg/dL) were less likely (odds ratio 0.55; 95% confidence interval 0.33-0.91) to suffer from DR than patients in Q1 (i.e. serum bilirubin <0.60 mg/dL).
  
  
  CONCLUSIONS
  Serum bilirubin concentrations were inversely associated with DR in an elderly Chinese population, independent of traditional risk factors for microvascular complications.
authors.affiliation: Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai, China; Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China; National Institute for Biotechnology and Genetic Engineering, Faisalabad, Pakistan.
authors.forename: Syeda Sadia
authors.initials: SS
authors.lastname: Najam
authors.forename: Jichao
authors.initials: J
authors.lastname: Sun
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.forename: Min
authors.initials: M
authors.lastname: Xu
authors.forename: Jieli
authors.initials: J
authors.lastname: Lu
authors.forename: Kan
authors.initials: K
authors.lastname: Sun
authors.forename: Mian
authors.initials: M
authors.lastname: Li
authors.forename: Tiange
authors.initials: T
authors.lastname: Wang
authors.forename: Yufang
authors.initials: Y
authors.lastname: Bi
authors.forename: Guang
authors.initials: G
authors.lastname: Ning
mesh_terms: D000368:Aged; D044466:Asian People; D001663:Bilirubin / Q000097:blood*; D015992:Body Mass Index; D002681:China / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000208:ethnology; D003930:Diabetic Retinopathy / Q000097:blood* / Q000208:ethnology / Q000209:etiology; D004326:Drinking; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking; D014280:Triglycerides / Q000097:blood
chemical_list: D001663:Bilirubin; D002784:Cholesterol; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D014280:Triglycerides
keywords: bilirubin; diabetes mellitus; diabetic complications; retinopathy; 胆红素，糖尿病，糖尿病并发症，视网膜病变