Association of bilirubin and malondialdehyde levels with retinopathy in type 2 diabetes mellitus.
BACKGROUND
Bilirubin as an antioxidant and malondialdehyde (MDA) as an oxidant have been shown to be associated with various complications of type 2 diabetes mellitus (DM).


OBJECTIVE
The aim was to measure the levels of serum bilirubin and MDA in type 2 DM patients with and without diabetic retinopathy (DR) and to correlate them with severity of DR.


METHODS
A total number of 120 subjects out of which 40 were controls without type 2 DM and the rest 80 were type 2 DM patients were included in the study. Of those 80 diabetics, 44 patients did not have DR and 36 patients had DR.


RESULTS
The total bilirubin, direct bilirubin, indirect bilirubin were higher in controls as compared to cases (P = 0.017, 0.033, 0.024). Serum MDA levels were found to be higher in diabetics as compared to controls (P = 0.00). The values of all the three parameters, that is, total bilirubin, direct bilirubin and indirect bilirubin were lower in patients with retinopathy as compared to those without retinopathic changes (P = 0.00, 0.020, and 0.007). Subjects were assigned to quartiles based on serum total bilirubin concentration. The prevalence of DR was significantly lower among persons with the highest bilirubin quartile compared to those with the lowest quartile. The severity of DR was inversely proportional to the total bilirubin levels (P = 0.001). The multiple logistic regression analysis showed total bilirubin to be associated with prevalence of DR (P = 0.035).


CONCLUSIONS
The levels of total bilirubin were significantly lower in patients with DR and also in the late stages of retinopathy as compared to those without retinopathy and in controls but MDA levels did not show any association with DR.
Department of Endocrinology, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India.
Apoorva
A
Dave
Department of Endocrinology, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India.
Pramila
P
Kalra
Department of Biochemistry, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India.
B H Rakshitha
BH
Gowda
Department of Ophthalmology, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India.
Malavika
M
Krishnaswamy
Bilirubin; malondialdehyde; retinopathy; type 2 diabetes mellitus