Observation Of Serum Bilirubin And Clinical Indicators In People With Different Glucose Metabolism Status

Objective: To observe the serum bilirubin concentration and related metabolic index levels of people with different glucose metabolism states,and to explore the characteristics of glucose metabolism indicators under different bilirubin levels and the influencing factors of diabetes.Methods: A retrospective analysis was performed on the people who came to the Endocrinology Department of Qinghai University Affiliated Hospital for diabetes screening from 2019 to 2021,and the glucose tolerance test(OGTT),C-peptide and insulin release tests were improved.According to the OGTT results,the data were divided into diabetes group(DM),impaired glucose regulation group(IGR)and normal blood glucose group(NGT),and the general clinical data,physical examination results and biochemical indicators of the three groups of people were collected and compared.The populations were then divided into high bilirubin group and normal bilirubin group according to the serum total bilirubin level,and then compared the changes in their glucose metabolism indexes,and finally used logistic regression to analyze the independent risk factors for T2 DM.Results:(1)Among the 464 participants,the levels of TBIL,HDL-C,UA,Scr,HOMA-β decreased with the progression of glucose metabolism in the three groups of NGT,IGR and T2 DM,and the levels of TBIL,HDL-C,UA,Scr,HOMA-βdecreased(P <0.05).(2)The stepwise linear regression showed that TBIL was mainly affected by the positive effects of Hb,ALT,AST and UA and the negative effects of TC(P<0.05).DBIL was mainly affected by the positive effects of Hb and Scr and the negative effects of TG and TC(P<0.05).IBIL is mainly affected by the positive effects of Hb,AST,ALT,gender and the negative effects of age.(P<0.05).(3)Logistic regression analysis showed that TBIL(OR=0.997,95%CI0.939～1.016,P=0.023),TG(OR=0.716,95%CI1.248～2.360,P=0.001),TC(OR=0.432,95%CI 0.210～0.887,P=0.022),LDL-C(OR=3.156,95%CI 1.595～6.247,P=0.001),HOMA-β(OR=0.979,95%CI 0.939～1.016,P<0.001).Another,regression analysis of IBIL the subtype of TBIL showed that(OR=0.950,95%CI 0.911～0.992,P=0.020),TG(OR=1.736,95%CI1.258～2.396,P=0.001),TC(OR=0.442,95%CI0.214～0.909,P=0.027),LDL-C(OR=3.174,95%CI 1.605～6.728,P=0.001),HOMA-β(OR=0.979,95%CI0.973～0.984,P<0.001).It shows that TBIL(including IBIL)and HOMA-β are independent protective factors for reducing the occurrence of T2 DM,and TG,TC,and LDL-C are independent risk factors affecting the occurrence of T2 DM.(4)Divided by total bilirubin(TBIL)value(17.1 μmol/L),the high bilirubin group(17.1～34.2 μmol/L)and the normal bilirubin group(< 17.1 μmol/L)were divided.In this context,a comparison of the changes in glucose metabolism indices of the three groups of people found that the blood glucose,C-peptide and insulin levels at various time points in the high bilirubin group were different from those of the normal bilirubin level group(P<0.05).Among them,the NGT population had higher C-peptide and HOMA-β and lower insulin levels(P<0.05).In the high bilirubin group,and the IGR population had lower blood glucose,insulin levels and HOMA-βand HOMA-IR values in the high bilirubin group,and the C-peptide level was higher(P<0.05),and there was no significant difference in the indicators of the T2 DM population(P>0.05).Suggests that serum bilirubin may have a protective effect on islet function.Conclusion: 1.The levels of total bilirubin,direct bilirubin,and indirect bilirubin in the new-onset T2 DM and IGR population were lower than those in the NGT population,and with the gradual progress of glucose metabolism,the bilirubin level showed a gradual downward trend.2.TG,TC,and LDL-C are independent risk factors for T2 DM,at 34.2μmol/L,the risk of T2 DM decreased gradually with the increase of serum bilirubin level.3.In the protective effect of bilirubin on reducing the occurrence of T2 DM,its subtype indirect bilirubin plays the main role.