title: Low serum bilirubin concentration is a novel risk factor for the development of albuminuria in patients with type 2 diabetes.
abstract: OBJECTIVE
  Bilirubin has been recognized as an important endogeneous antioxidant. Previous studies reported that bilirubin could prevent atherosclerosis. The aim of this study was to investigate if serum bilirubin concentration could be a predictor for the development of albuminuria in patients with type 2 diabetes.
  
  
  METHODS
  We measured serum bilirubin in 320 consecutive patients with normoalbuminuria. We performed follow-up study to assess the development of albuminuria, mean interval of which was 3.2±0.9years. Cox proportional hazards regression was used to examine the relationship between serum bilirubin concentration and the development of albuminuria.
  
  
  RESULTS
  During follow-up duration, 43 patients have developed albuminuria. In multivariate analysis, after adjusting for comprehensive risk factors, the risk of developing albuminuria was higher in the lowest quartile of serum bilirubin concentrations than that in the highest quartile of serum bilirubin concentrations (Hazard ratio, 5.76; 95% CI, 1.65 to 24.93).
  
  
  CONCLUSIONS
  Low serum bilirubin concentration could be a novel risk factor for the development of albuminuria in patients with type 2 diabetes.
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Hiroshi
authors: H
authors: Okada
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. Electronic address: sayarinapm@hotmail.com.
authors: Michiaki
authors: M
authors: Fukui
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Muhei
authors: M
authors: Tanaka
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Shinobu
authors: S
authors: Matsumoto
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Kanae
authors: K
authors: Kobayashi
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Hiroya
authors: H
authors: Iwase
authors: Department of Cardiology, Kyoto Yamashiro General Medical Center, Japan.
authors: Kiichiro
authors: K
authors: Tomiyasu
authors: Department of Endocrinology and Metabolism, Kyoto Yamashiro General Medical Center, Japan.
authors: Koji
authors: K
authors: Nakano
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Goji
authors: G
authors: Hasegawa
authors: Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
authors: Naoto
authors: N
authors: Nakamura
mesh_terms: D000419:Albuminuria / Q000097:blood / Q000209:etiology*; D001663:Bilirubin / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001663:Bilirubin
keywords: Diabetes; Diabetic nephropathy; Endogeneous antioxidant