Total bilirubin level may be a biomarker of nephropathy in type 2 diabetes mellitus

Zhang, Dan; Zhu, Bo; Zhang, Wei; Wang, Wei; Guo, Dan; Yang, Ligang; Wang, Lu

doi:10.1097/md.0000000000005765

Cited by 7 publications

(9 citation statements)

References 31 publications

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“…This approximates the results shown by others [19], who observed that total proteins level was increased in diabetics as compared to controls, while a significant reduction of serum TB level was recorded in diabetic male and female patients with both age ranges in comparison with those in control groups. These results are in accordance with those obtained by others [20,21]. The observed increase in serum total protein in diabetic patients may be explained on the basis of the elevation of different acute phase proteins, globulins, and fibrinogen in DM, which is compounded by a decrease in the fractional synthetic rate of albumin due to insulin resistance or insulin deficiency, which contribute to the elevation in plasma proteins [11].…”

Section: Serum Levels Of Liver Function Markerssupporting

confidence: 92%

Indications of Liver and Kidney Functions in Non-Insulin Dependent Diabetic Patients

Balaky

Kakey

2021

eijs

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This study aimed at the investigation of abnormal liver and renal functions by biochemical manifestations of underlying metabolic abnormalities in relation to hyperglycemia in non-insulin-dependent diabetic patients. The study comprised 118 diabetic patients (56 males, 62 females) and 60 age-matched healthy non-diabetic controls (30 males, 30 females). All subjects were tested for serum levels of liver enzymatic indicators, which include aspartate transaminase (AST), alanine transaminase (ALT), and alkaline phosphatase (ALP), as well as non enzymatic parameters, including total bilirubin and total proteins.Also, serum levels of renal function markers, including microalbumin, creatinine, urea, and uric acid were measured. The findings of this study stated that serum ALT, AST, and ALP levels were significantly higher in diabetic males and females with both age ranges (40-59 & 60-80 years). Serum total bilirubin level showed a significant decrease in diabetic males and females of both age groups. However, total proteins level showed a significant increase in diabetic males and females of both age groups. The results also showed that the level of microalbumin in urine as well as those of creatinine, urea, and uric acid in the serum were significantly higher in diabetic males and females. The present study concludes that there is a bidirectional relationship of enzymatic and non enzymatic liver and renal functions markers with the hyperglycemic status in Type 2 diabetes mellitus.

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Section: Serum Levels Of Liver Function Markerssupporting

confidence: 92%

Indications of Liver and Kidney Functions in Non-Insulin Dependent Diabetic Patients

Balaky

Kakey

2021

eijs

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“…Although KIM-1, GDF-15, and TBIL were previously reported to contribute to tubular injury ( 31 , 32 ) and predict the progression of CKD ( 4 – 8 ). Our data did not show the causally link of these molecules with DN.…”

Section: Discussionmentioning

confidence: 99%

“…Growth differentiation factor-15 (GDF-15) was reported to be a predictor of the rapid deterioration of renal function ( 6 , 7 ). A recent meta-analysis indicated that total bilirubin level was negatively correlated with the risk of DN ( 8 ). Another meta-analysis of 25741 T2DM patients revealed that each increase of 1mg/dl of serum uric acid could increase the risk of DN by 24% ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Mendelian randomization study supports the causal association between serum cystatin C and risk of diabetic nephropathy

Feng

et al. 2022

Front. Endocrinol.

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AimsCystatin C, an inhibitor of cysteine protease, has been used as a biomarker for estimating glomerular filtration rate. However, the causal relation between cystatin C and diabetic nephropathy remains uncertain.MethodsWe assessed the causal effect of cystatin C together with other five serum biomarkers including KIM-1, GDF-15, TBIL, uric acid, and Scr on diabetic nephropathy by Mendelian randomization (MR) analysis. 234 genetic variants were selected as instrumental variables to evaluate the causal effect of cystatin C (NGWAS=361194) on diabetic nephropathy (Ncase/Ncontrol up to 3283/210463). Multivariable MR (MVMR) was performed to assess the stability of cystatin C’s causal relationship. Two-step MR was used to assess the mediation effect of BMI and SBP.ResultsAmong the six serum biomarkers, only cystatin C causally associated with diabetic nephropathy (IVW OR: 1.36, 95%CI [1.15, 1.61]). After adjusting for the potential confounders BMI and SBP, cystatin C maintained its causal effect on the DN (OR: 1.17, 95%CI [1.02, 1.33]), which means that the risk of DN increased by 17% with an approximate 1 standard deviation (SD) increment of serum cystatin C level. Two-step MR results indicated that BMI might mediate the causal effect of cystatin C on diabetic nephropathy.InterpretationOur findings discovered that cystatin C was a risk factor for diabetic nephropathy independent of BMI and SBP in diabetes mellitus patients. Future research is required to illustrate the underlying mechanism and prove targeting circulating cystatin C could be a potential therapy method.

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“…For instance, it is a potent antioxidant as well as an anti-inflammatory factor that is capable of scavenging various reactive oxygen species and free radicals 1,2, as well as counteracting oxidative stress 3,4. Many epidemiological studies have observed an inverse relationship between bilirubin and a number of pathological abnormalities, such as cardiovascular diseases 5, metabolic syndrome 6, dyslipidemia 7, and diabetes 8,9. However, we retrieved only two previous investigations studying the association between bilirubin and white blood cell (WBC) count, and there was some discordance 10,11.…”

Section: Introductionmentioning

confidence: 99%

Serum bilirubin is negatively associated with white blood cell count

Zhang¹,

Zhang²,

Meng³

et al. 2019

Clinics

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OBJECTIVE: Bilirubin is considered an important antioxidant, anti-inflammatory factor and immunomodulator. The current investigation aimed to explore the association between bilirubin and white blood cell (WBC) count in a large Chinese cohort. METHODS: A total of 61091 participants (29259 males, 31832 females) were recruited from a Chinese tertiary hospital. Data were sorted by sex, and the association between bilirubin and WBC count was analyzed after dividing bilirubin levels into quartiles. RESULTS: Most parameters (including age, body mass index, systolic blood pressure, diastolic blood pressure, alanine aminotransferase, total bilirubin, blood urea nitrogen, creatinine, uric acid, triglycerides and WBC count) were significantly higher in men than in women. Bilirubin displayed significant negative relationships with most other measured variables. Linear logistic regression analysis further indicated their negative relationships. Females showed a significantly higher frequency of leucopenia than males. Significant associations of leucopenia with high bilirubin quartiles were shown in binary logistic regression models for both sexes, with a much closer association in men than in women. For instance, for men with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.600-times higher than that of men with values in quartile 1. For women with bilirubin levels in quartile 4, the adjusted likelihood of leucopenia was 1.135-times higher than that of women with values in quartile 1. CONCLUSION: Bilirubin is negatively related to WBC count. Significant associations exist between leucopenia and high bilirubin quartiles, and these associations are more obvious in men than in women.

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Total bilirubin level may be a biomarker of nephropathy in type 2 diabetes mellitus

Cited by 7 publications

References 31 publications

Indications of Liver and Kidney Functions in Non-Insulin Dependent Diabetic Patients

Indications of Liver and Kidney Functions in Non-Insulin Dependent Diabetic Patients

Mendelian randomization study supports the causal association between serum cystatin C and risk of diabetic nephropathy

Serum bilirubin is negatively associated with white blood cell count

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