Low serum bilirubin levels contribute to the presence and progression of distal symmetrical polyneuropathy in Chinese patients with type 2 diabetes
Low serum bilirubin levels contribute to the presence and progression of distal symmetrical polyneuropathy in Chinese patients with type 2 diabetes
复制标题
低血清胆红素水平导致中国 2 型糖尿病患者远端对称性多发性神经病的出现和进展
DOI：
10.1016/j.diabet.2018.02.007
复制
发表时间：
2019-01-01
影响因子：
7.2
通讯作者：
Zhu, D.
中科院分区：
文献类型：
--
作者：
Jin, J.;Wang, W.;Zhu, D.
瞄准- 目的探讨血清胆红素水平与中国2型糖尿病（T2 D）患者远端对称性多发性神经病（DSPN）的关系。- 2014年6月至2017年3月期间，共连续入组了1800例T2 D住院患者（包括68例1年随访）。DSPN是根据2010年多伦多糖尿病神经病变专家组推荐的标准诊断的。回顾性收集临床资料。- 与无DSPN的患者相比，血清总胆红素（9.9 +/- 3.1 μ mol/L vs. 10.7 +/- 2.8 μ mol/L; P < 0.01）和非结合胆红素（6.7 +/- 2.2 μ mol/L vs. 7.3 f 2.1 μ mol/L; P < 0.01）水平分别较低。胆红素水平最低的患者DSPN发生率最高，神经传导速度（NCV）最慢。多变量校正后，低水平的非结合胆红素是DSPN存在的风险因素（OR：0.696，95% CI：0.494-0.981; P = 0.038，最高vs.最低）。此外，在68例接受1年随访的患者中，血清胆红素最低三分位数的患者NCV恶化最严重。即使经过多变量调整，这些变化仍然显着。结论。- 低水平的血清胆红素，尤其是非结合胆红素，有助于中国T2 D患者DSPN的存在和进展。因此，血清未结合胆红素可作为DSPN风险和进展的额外指标。(C)2018年由Elsevier Masson SAS出版。
Aim. - To investigate the association between serum bilirubin and distal symmetrical polyneuropathy (DSPN) in Chinese patients with type 2 diabetes (T2D).Methods. - A total of 1800 inpatients with T2D (including 68 with 1-year follow-ups) were consecutively enrolled between June 2014 and March 2017. DSPN was diagnosed according to criteria recommended by the Toronto Diabetic Neuropathy Expert Group in 2010. Clinical data were retrospectively collected.Results. - Patients with vs. without DSPN had low levels of serum total bilirubin (9.9 +/- 3.1 mu mol/L vs. 10.7 +/- 2.8 mu mol/L; P < 0.01) and unconjugated bilirubin (6.7 +/- 2.2 mu mol/L vs. 7.3 f 2.1 mu mol/L; P < 0.01), respectively. Patients in the lowest tertiles of bilirubin had the highest rates of DSPN and slowest nerve conduction velocities (NCVs). After multivariate adjustment, low levels of unconjugated bilirubin were a risk factor (OR: 0.696, 95% CI: 0.494-0.981; P = 0.038, highest vs. lowest) for the presence of DSPN. Furthermore, in the 68 patients who had 1-year follow-ups, those with the lowest tertiles of serum bilirubin showed maximum deterioration in NCVs. These changes remained significant even after multivariate adjustment.Conclusion. - Low levels of serum bilirubin, especially unconjugated bilirubin, contributed to the presence and progression of DSPN in Chinese patients with T2D. Thus, serum unconjugated bilirubin may be used as an additional indicator of risk and progression of DSPN. (C) 2018 Published by Elsevier Masson SAS.