14 December 2017 : Clinical Research
Inverse Relationship Between Serum Bilirubin Levels and Diabetic Foot in Chinese Patients with Type 2 Diabetes MellitusJifan Chen1BCDE, Jian Wang1BEF, Xingxing Zhang2F, Hong Zhu2AEG*
Med Sci Monit 2017; 23:5916-5923
BACKGROUND: Several studies demonstrated that bilirubin, a potent endogenous antioxidant, is a strong protective factor for many diabetic complications such as nephropathy, retinopathy, neuropathy, and vasculopathy. The purpose of this study was to assess the association between serum bilirubin levels and diabetic foot (DF) in Chinese patients with type 2 diabetes mellitus (T2DM).
MATERIAL AND METHODS: The present cross-sectional study of bilirubin levels in relation to DF was conducted in 1,269 T2DM patients with (n=578) and without (n=691) DF. Blood test results were obtained on hospital admission, including total bilirubin (T-BIL), direct bilirubin (D-BIL), and indirect bilirubin (I-BIL). Data on Wagner classification and amputation procedure in patients with DF were collected by reviewing electronic medical records. Univariate or multivariate analysis were performed to explore the association between bilirubin and DF.
RESULTS: Serum I-BIL levels were shown to play a protective role regarding the presence and severity of DF (OR=0.75, p=0.029 and OR=0.90, p=0.021, respectively). In addition, in a comparison of the lowest and highest tertiles of serum bilirubin concentration, the highest tertile of serum T-BIL (OR=0.51, p=0.011) and I-BIL (OR=0.28, p<0.001) was significantly related with a lower Wagner grade of DF. Patients with DF in the highest tertiles of T-BIL carried a significantly lower risk of amputation events than those in the lowest tertiles (OR=0.47, p=0.025).
CONCLUSIONS: The present study provided evidence that decreased serum bilirubin levels were independently associated with the presence and severity of DF and amputation events in patients with DF.
Keywords: Amputation, bilirubin, Diabetes Mellitus, Diabetic Foot, Diabetic Neuropathies, peripheral arterial disease
01 May 2022 : EditorialEditorial: Cardiovascular Complications at One Year After SARS-CoV-2 Infection are Independent of Underlying Cardiovascular Risk Factors or Severity of COVID-19
Med Sci Monit 2022; 28:e937048
04 May 2022 : Clinical ResearchEffects of Wearing Face Masks on Exercise Capacity and Ventilatory Anaerobic Threshold in Healthy Subjects ...
Med Sci Monit In Press; DOI: 10.12659/MSM.936069
22 April 2022 : Clinical ResearchFactors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)
Med Sci Monit In Press; DOI: 10.12659/MSM.936547
27 April 2022 : Meta-AnalysisEffect of the COVID-19 Pandemic on Serum Vitamin D Levels in People Under Age 18 Years: A Systematic Review...
Med Sci Monit In Press; DOI: 10.12659/MSM.935823
19 May 2022 : Clinical ResearchAssociation Between Serum Homocysteine Levels and Severity of Diabetic Kidney Disease in 489 Patients with ...
Med Sci Monit In Press; DOI: 10.12659/MSM.936323
18 May 2022 : Clinical ResearchPhysical and Psychosocial Concept Domains Related to Health-Related Quality of Life (HRQL) in 50 Girls and ...
Med Sci Monit In Press; DOI: 10.12659/MSM.936801
18 May 2022 : Clinical ResearchAssociation Between Variants of the Mannose-Binding Lectin 2 Gene and Susceptibility to Sepsis in the Haina...
Med Sci Monit In Press; DOI: 10.12659/MSM.936134
Most Viewed Current Articles
30 Dec 2021 : Clinical ResearchRetrospective Study of Outcomes and Hospitalization Rates of Patients in Italy with a Confirmed Diagnosis o...
Med Sci Monit 2021; 27:e935379
08 Mar 2022 : Review articleA Review of the Potential Roles of Antioxidant and Anti-Inflammatory Pharmacological Approaches for the Man...
Med Sci Monit 2022; 28:e936292
01 Nov 2020 : Review articleLong-Term Respiratory and Neurological Sequelae of COVID-19
Med Sci Monit 2020; 26:e928996