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外文期刊>The Korean Journal of Internal Medicine
>Ahn, Kim, Kim, Kim, Nam, Park, Jeon, Kim, Kim, and Kim: Low serum bilirubin level predicts the development of chronic kidney disease in patients with type 2 diabetes mellitus
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Ahn, Kim, Kim, Kim, Nam, Park, Jeon, Kim, Kim, and Kim: Low serum bilirubin level predicts the development of chronic kidney disease in patients with type 2 diabetes mellitus
Background/Aims We evaluated whether serum bilirubin levels can predict the development of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM). Methods This was a retrospective observational longitudinal study of patients presenting at the Pusan National University Hospital. A total of 349 patients with T2DM and preserved kidney function (estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2) were enrolled. The main outcome was the development of CKD stage 3 or greater. The patients were divided into four groups according to the quartiles of the total serum bilirubin levels at baseline. Results The group with the lowest range of total serum bilirubin level (Q1) showed the highest cumulative incidence of CKD stage 3 or greater than that of the other lower quartiles (Q1 vs. Q4; hazard ratio [HR], 6.75; 95% confidence interval [CI], 1.54 to 29.47; p = 0.011). In multivariate analysis, the risk of developing CKD stage 3 or greater was higher in the second lowest quartile of the serum bilirubin level than that in the highest quartile of the serum bilirubin level (Q2 vs. Q4; HR, 9.36; 95% CI, 1.33 to 65.73; p = 0.024). In the normoalbuminuria subgroup (n = 236), multivariate analysis showed that the risk of developing CKD stage 3 or greater was higher in the lowest quartile of the serum bilirubin level than that in the highest quartile of the serum bilirubin level (Q1 vs. Q4; HR, 7.36; 95% CI, 1.24 to 35.82; p = 0.019). Conclusions Serum bilirubin might be an early clinical marker for predicting the progression of CKD in patients with T2DM and preserved renal function.
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机译：背景/目的我们评估血清胆红素水平是否可以预测2型糖尿病（T2DM）的患者慢性肾病（CKD）的发育。方法是，这是在釜山国家大学医院患者的回顾性观察纵向研究。共有349例T2DM和保存的肾功能患者（估计肾小球过滤率≥60mL/ min / 1.73 m 2 ）。主要结果是CKD第3阶段的发展。根据基线的总血清胆红素水平的四分位数，将患者分为四组。结果具有最低血清胆红素水平（Q1）的基团显示出CKD阶段3的最高累积发生率或大于其他低四分位数（Q1与Q4;危险比[HR]，6.75; 95％的信心间隔[CI]，1.54至29.47; P = 0.011）。在多变量分析中，在血清胆红素水平的第二个最低四分位数中显影CKD阶段3或更大的风险比血清胆红素水平的最高四分位数（Q2对Q4; HR，9.36; 95％CI， 1.33至65.73; p = 0.024）。在Normoalbumumuria亚组（n = 236）中，多变量分析表明，在血清胆红素水平的最低四分位数中，在血清胆红素水平的最高四分位数中，在血清胆红素水平的最低四分位数（Q1对Q4 ; HR，7.36; 95％CI，1.24至35.82; p = 0.019）。结论血清胆红素可能是一种早期临床标记，用于预测T2DM患者的CKD进展和保存肾功能。
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