title: Does bilirubin protect against developing diabetes mellitus?
abstract: After 25 years of evaluating bilirubin as a possible protective agent in neonatal and cardiovascular disease, interest has moved on to a exploring a possible protective role in diabetes mellitus (DM). This review finds conflicting prospective data for a protective relationship though there are retrospective, case-controlled data, that can only show association, which is not causality. Only prospective studies can show causality. Also, it would appear that the underlying biochemical assumptions do not readily translate from the animal to the human setting. Given that many factors impact on circulating bilirubin levels, it is not surprising that a clear-cut answer is not available; the jury is still out. Any relationship between DM and bilirubin might relate to intermediates in bilirubin metabolism, including relationships involving the genes for the enzymes participating in those steps. Nevertheless, the pursuit of bilirubin in disease causation is opening new avenues for research and if it is established that serum bilirubin can predict risks, much will have been achieved. The answer may have to come from molecular genetic analyses.
authors.affiliation: Dept of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro University Hospital, SE-701 85, Örebro, Sweden. Electronic address: lars.breimer@regionorebrolan.se.
authors.forename: Lars H
authors.initials: LH
authors.lastname: Breimer
authors.affiliation: Dept. of Clinical Biochemistry (Vascular Disease Prevention Clinics), Royal Free campus, University College London Medical School, University College London (UCL), London, NW3 2QG, UK.
authors.forename: Dimitri P
authors.initials: DP
authors.lastname: Mikhailidis
mesh_terms: D000818:Animals; D001663:Bilirubin / Q000097:blood* / Q000378:metabolism; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood / Q000453:epidemiology*; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000502:physiology; D008954:Models, Biological; D018384:Oxidative Stress; D012307:Risk Factors
chemical_list: D001663:Bilirubin
keywords: Bilirubin; Diabetes mellitus; Genetic analysis; Oxidant stress; Prospective studies