title: Effect of bilirubin concentration on the risk of diabetic complications: A meta-analysis of epidemiologic studies.
abstract: Diabetes can affect many parts of the body and is associated with serious complications. Oxidative stress is a major contributor in the pathogenesis of diabetic complications and bilirubin has been shown to have antioxidant effects. The number of studies on the effect of bilirubin on the risk of diabetic complications has increased, but the results are inconsistent. Thus, we performed a meta-analysis to determine the relationship between bilirubin concentration and the risk of diabetic complications, and to investigate if there was a dose-response relationship. We carried out an extensive search in multiple databases. A fixed or random-effects model was used to calculate the pooled estimates. We conducted a dose-response meta-analysis to analyze the association between these estimates. A total of 132,240 subjects from 27 included studies were analyzed in our meta-analysis. A negative nonlinear association between bilirubin concentration and the risk of diabetic complications was identified (OR: 0.77, 95% CI: 0.73-0.81), with a nonlinear association. We also found that there was a negative association between bilirubin concentration and the risk of diabetic nephropathy, diabetic retinopathy and diabetic neuropathy. The results of our meta-analysis indicate that bilirubin may play a protective role in the occurrence of diabetic complications.
authors.affiliation: Department of Cancer Prevention and Treatment, Cancer Hospital of China Medical University/Liaoning Cancer Hospital &Institute Shenyang, People's Republic of China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhu
authors.affiliation: Department of Clinical Epidemiology and Evidence Medicine, The First Hospital of China Medical University, Shenyang, People's Republic of China.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Wu
authors.affiliation: Leiden University Center for Linguistics and Leiden Institute for Brain and Congnition, leiden, zuid-holland, Netherlands.
authors.forename: Yifei
authors.initials: Y
authors.lastname: Bi
authors.affiliation: Department of mathematics, School of Fundamental Sciences, China Medical University, Shenyang, People's Republic of China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D048909:Diabetes Complications / Q000097:blood* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D001663:Bilirubin