Interactive effect of serum uric acid and total bilirubin for cardiovascular disease in Chinese patients with type 2 diabetes.
Serum uric acid (SUA) at high levels and bilirubin at low levels were potent antioxidant but it was uncertain that whether SUA and total bilirubin (TBIL) had additive interaction for the risk of CVD in type 2 diabetes mellitus (T2DM). We conducted a cross-sectional survey of 6713 inpatients with T2DM and admitted to 81 tertiary care hospitals. CVD was defined as having either prior coronary heart disease or stroke or peripheral arterial disease. Binary logistic regression was used to estimate odds ratios of SUA and TBIL for CVD. The effect size of additive interaction was estimated by three measures, i.e., relative excess risk due to interaction, attributable proportion due to interaction and synergy index. Among 6713 patients with T2DM, 561 (8.36%) suffered from CVD. Using ≥283 umol/L (median) to define high SUA and <11.5 umol/L (n = 2290 or 34.11%) to define low TBIL, copresence of both factors (n = 621 or 9.25%) was associated with 5.18-fold (95% CI, 4.00-6.72) risk of CVD with significant additive interactions in multivariable analysis as compared to absence of both risk factors. The copresence of both high SUA and low TBIL was associated with a large increased risk of CVD in high-risk Chinese patients with type 2 diabetes.
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.|Department of Health Statistics, School of Public Health and Management, Weifang Medical University, Shandong, China.
Yanfeng
Y
Ren
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Nan
N
Jin
Department of Endocrinology, Peking University Third Hospital, Beijing, China.
Tianpei
T
Hong
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Yiming
Y
Mu
Department of Endocrinology, Beijing Hospital, Beijing, China.
Lixin
L
Guo
Department of Endocrinology, The Fourth Military Medical University Xi Jing Hospital, Xi'an, China.
Qiuhe
Q
Ji
Department of Endocrinology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.
Qiang
Q
Li
Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
Xilin
X
Yang
Department of Endocrinology, Peking University People's Hospital, Beijing, China.
Linong
L
Ji
D000368:Aged; D044466:Asian People; D001663:Bilirubin / Q000097:blood; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis*; D002681:China; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D014527:Uric Acid / Q000097:blood
D014527:Uric Acid; D001663:Bilirubin