Association between total serum bilirubin concentration and vascular complication risk in type 2 diabetes mellitus

We studied the association between total serum bilirubin concentration (TBC) and vascular complications in type 2 diabetes based on the TBCs of 171 subjects compared to those with and without diabetic microangiopathy (Micro) and to those with and without macroangiopathy (Macro), i.e., cerebral infarction (CI), coronary artery disease (CAD), and peripheral arterial disease (PAD). Stepwise regression analysis was used to determine the effects of various factors on TBC, considering the following factors as independent variables: gender, age, diabetic duration, HbAlc, Micro, Macro, systolic blood pressure (SBP), lipid profile, alcohol intake, and smoking. Logistic regression analysis was used to determine the effects of these factors on Micro/Macro, considering the following factors as independent variables: TBC, gender, age, diabetic duration, HbAlc, SBP, lipid profile, and smoking. TBCs were significantly lower in those with retinopathy, nephropathy, CI, and PAD compared to those in subjects without complications. Micro and Macro were independent factors for TBC, while TBC, diabetic duration, SBP, and smoking were independent factors for Micro. TBC was the only explanatory variable for Macro. Low serum TBC could therefore be an important factor for the incidence of both Micro and Macro in type 2 diabetes.