Association Between Serum Bilirubin and the Progression of Carotid Atherosclerosis in Type 2 Diabetes

이인국; 이혁희; Yongin Cho; 최영주; Byoung Wook Huh; byung wan lee; Eun Seok Kang; BONG SOO CHA; EUN JIG LEE; Yong Ho Lee; 허갑범

Association Between Serum Bilirubin and the Progression of Carotid Atherosclerosis in Type 2 Diabetes

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Type: Academic journal

Author: 이인국 이혁희 Yongin Cho 최영주 Byoung Wook Huh byung wan lee Eun Seok Kang BONG SOO CHA EUN JIG LEE Yong Ho Lee 허갑범

Journal: 한국지질동맥경화학회(구 한국지질학회) 지질·동맥경화학회지 지질·동맥경화학회지 제9권 제1호 KCI Accredited Journals

Published: 2020.1

Pages: 195 - 204 (10page)

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Association Between Serum Bilirubin and the Progression of Carotid Atherosclerosis in Type 2 Diabetes

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Objective This study investigated whether serum bilirubin levels can predict the progression of carotid atherosclerosis in individuals with type 2 diabetes mellitus (T2DM). Methods This observational study included 1,381 subjects with T2DM in whom serial measurements of carotid intima-media thickness (CIMT) were made at 1- to 2-year intervals for 6–8 years. The progression of carotid atherosclerosis was defined as newly detected plaque lesions on repeat ultrasonography. After dividing total serum bilirubin levels into tertiles, the association between total serum bilirubin at baseline and plaque progression status was analyzed. Results Among 1,381 T2DM patients, 599 (43.4%) were categorized as having plaque progression in their carotid arteries. Those with plaque progression were significantly older; showed a higher prevalence of hypertension, abdominal obesity, and chronic kidney disease; and had a longer duration of T2DM, higher levels of total cholesterol (TC), triglycerides, and insulin resistance, and lower total bilirubin concentrations than those with no plaque progression. When total serum bilirubin levels were divided into tertiles, the highest tertile group was younger than the lowest tertile group, with higher levels of TC and high-density lipoprotein cholesterol. Multiple logistic regression analysis demonstrated that higher serum bilirubin levels were associated with a significantly lower risk of CIMT progression (odds ratio, 0.584; 95% confidence interval, 0.392–0.870; p=0.008). Age (p<0.001), body mass index (p=0.023), and TC (p=0.019) were also associated with the progression of carotid atherosclerosis in T2DM patients. Conclusion Total serum bilirubin is independently associated with progression of atherosclerosis in the carotid arteries in T2DM patients.

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Zheng Y / 2018 / Global aetiology and epidemiology of type 2 diabetes mellitus and its complications / Nat Rev Endocrinol 14:88~98

Emerging Risk Factors Collaboration / 2010 / Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease : a collaborative meta-analysis of 102 prospective studies / Lancet 375:2215~2222

Kim SK / 2014 / Nonalcoholic Fatty liver disease is associated with increased carotid intima-media thickness only in type 2 diabetic subjects with insulin resistance / J Clin Endocrinol Metab 99:1879~1884

한유진 / 2017 / Non-Alcoholic Fatty Liver Disease: The Emerging Burden in Cardiometabolic and Renal Diseases / Diabetes and Metabolism Journal 41(6):430~437

Lee EY / 2015 / Association between heme oxygenase-1 promoter polymorphisms and the development of albuminuria in type 2 diabetes: a case-control study / Medicine(Baltimore) 94:e1825

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