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- W1997646400 abstract "Background: Bilirubin is well known for its antioxidant and anti-inflammatory properties, and may protect against vascular disease. It has previously been demonstrated that higher bilirubin levels were associated with reduced peripheral arterial disease (PAD) prevalence, but the relationship with its consequence, lower limb amputation, is currently unknown. Methods: The relationship between baseline serum total bilirubin level and amputation was analysed in 9795 type 2 diabetic patients from the FIELD (Fenofibrate Intervention and Event Lowering in Diabetes) study in a pre-specified subsidiary analysis. Lower limb amputation was adjudicated blinded to treatment allocation. Relevant clinical and biochemical data were available for analyses. Bilirubin was analysed continuously using Cox regression techniques. Results: Bilirubin was significantly inversely associated with lower limb amputation rate. When bilirubin was analysed continuously, compared with those with higher levels, those with lower bilirubin levels had an increased risk of amputation (HR 1.40 per 5 μmol/L decrease in bilirubin, 95% CI 1.05–1.76, p = 0.013). The same association persisted after adjustment for age, sex, height, smoking status, GGT, ALT and HbA1c, treatment allocation (placebo vs. fenofibrate) and history of hypertension, hypercholesterolaemia, previous PAD, prior revascularisation, amputation, ulcer, neuropathy, renal dysfunction and diabetic retinopathy (p = 0.03). Conclusion: Our results identify, for the first time, a highly significant inverse relationship between bilirubin level and lower limb amputation rate. This would be consistent with the hypothesis that bilirubin plays a protective role against vascular injury." @default.
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- W1997646400 date "2011-01-01" @default.
- W1997646400 modified "2023-10-13" @default.
- W1997646400 title "Serum Total Bilirubin Levels Predict Amputation Events in Type 2 Diabetic Mellitus" @default.
- W1997646400 doi "https://doi.org/10.1016/j.hlc.2011.05.529" @default.
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