Abstract 815: Bilirubin Level as a Protective Factor for Diabetes Mellitus
Introduction: Diabetes Mellitus(DM) is a rampantly growing epidemic in the United States, affecting nearly 10% of the adult population. Studies have shown that higher levels of Total Bilirubin (TBili) convey a protective effect with regard to cardiovascular risk. In this study, we will examine the relationship between TBili level and prevalence of DM to discern whether a similar relationship exists.
Methods: The National Health and Nutrition Examination Survey (NHANES) is a comprehensive survey performed regularly to evaluate the overall health and nutrition status of the United States population. For the purpose of this study, we combined NHANES data collected between 1999 and 2006. 15,462 eligible participants were selected after excluding all patients younger than twenty years, those with a history of abnormal liver function tests, or those who disclosed a history of liver disease. The data collected on these individuals was adjusted for demographic characteristics, as well as risk factors for DM, and was analyzed via multivariate logistic regression, using SAS proc survey methodology.
Results: The age adjusted prevalence of DM(Types I and II) in the High TBili group(>11umol/L or 0.64mg/dl) was found to be 6.98%, in contrast to 9.8% in the Low TBili group(<11umol/L or 0.64mg/dl). After age adjustment, increased TBili was associated with 27% reduction in diabetes risk(OR 0.73; CI 0.63– 0.84). Multivariate analysis, adjusting for all diabetes risk factors assessed, confirmed this association(OR 0.77; CI 0.67 to 0.89).
Conclusion: Our results show that a higher level of serum TBili is associated with a lower incidence of DM. This finding supports the hypothesis that the antioxidant nature of TBili, demonstrating a protective effect with regard to the risk of stroke, atherosclerosis, and vasculitis in prior research, also extends to DM risk. Furthermore, research has shown that higher levels of TBili increase glucose mobilization into the cells, leading to more efficient, biologic glucose utilization. There is no doubt that the beneficial effect of TBili is multifactorial; thus further investigation is warranted.