Inverse Association between Serum Bilirubin Levels and Retinopathy in Patients with Type 2 Diabetes Mellitus
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 2
Abstract
Introduction: Oxidative stress plays a central role in the pathogenesis of Diabetic Retinopathy (DR) and serum bilirubin has been shown to have antioxidant properties. Aim: To investigate the association between serum bilirubin concentration and DR in patients with Type 2 Diabetes Mellitus (DM). Materials and Methods: This was a hospital based, crosssectional study where in 86 patients with Type 2 DM and 30 controls were recruited. The study was conducted at a tertiary care centre in Southern India between January 2014 and December 2014. The presence and the severity of DR were determined by fundus examination and grading of colour fundus photographs using the international clinical disease severity scale for DR. Serum total, direct and indirect bilirubin levels were determined in all subjects and the association between bilirubin levels and severity of DR was studied. Results: Among the 86 diabetics, 24 had no retinopathy and 62 had DR of varying grades. The mean total bilirubin level among diabetic subjects (0.52±0.17) and controls (0.51±0.19) were found to be similar. The mean total as well as direct bilirubin levels were found to be lower in patients with retinopathy as compared to no retinopathy group (p<0.001). The severity of DR was inversely proportional to the serum bilirubin levels (p=0.010). Serum total bilirubin was found to have a negative association with glycosylated haemoglobin and served as an independent determinant of DR even after adjusting for risk factors known to be associated with DR (p=0.001). Conclusion: Low serum bilirubin levels are significantly associated with increased risk of DR independent of classic risk factors. Serum bilirubin can serve as a useful biomarker in identifying patients at risk for developing proliferative DR.
Authors and Affiliations
Divya Karuppannasamy, Raghuram Venkatesan, Lekha Thankappan, Sundar Devisundaram
Keywords
Related Articles
- EP ID EP332347
- DOI 10.7860/JCDR/2017/24259.9452
- Views 100
- Downloads 0
Apolipoproteins an Early and Better Diagnostic Marker for Diabetic Retinopathy
Introduction: Diabetic Retinopathy (DR) is one of the most common microvascular complications of diabetes and is the leading cause of blindness and visual impairment worldwide. Dyslipidemia is the major biochemical alter...
Nasolabial Extraosseous Benign CD68+ Giant Cell Neoplasm with Low Malignant Potential
ABSTRACT The present case report highlights the histopathological features of a small nasolabial tumour in a 22-year-old female. The tumour was adequately excised. It consisted of proliferated Mononuclear Spindle (MNS) c...
Atypical Imaging Features of a Simple Intramuscular Lipoma
Lipoma is a benign tumour of mesenchymal tissue which closely resembles normal fat even histologically but for its biochemical and ultrastructural differences. Simple lipoma presents as a mass which resembles fat on all...
An Interesting and Rare Case of Urachal Adenocarcinoma Enteric Type with Review of Literature
ABSTRACT The urachus is a tubular structure that connects the bladder and allantois in the embryonic development, which involutes after third trimester. Urachal tumours are extremely rare and accounts of about 0.3-0.7% o...
Supraclavicular Brachial Plexus Block: Comparision of Two Different Doses of Dexmedetomidine as an Adjunct to Bupivacaine: A Study
ABSTRACT Introduction: Supraclavicular brachial plexus block is commonly performed for upper limb surgeries. A variety of adjuvants are added to the local anaesthetic to fasten the onset and prolong the duration of sens...