Relationship between serum bilirubin and UACR in patients with diabetic foot ulcer
Objective To analyze the relationship between serum bilirubin and urinary microalbumin/creatinine ratio(UACR)in patients with diabetic foot ulcer(DFU),in order to provide reference for the early prevention of urinary protein in patients with diabetic foot.Methods A total of 215 patients with diabetic foot ulcer were included in the Department of Endocrinology,the Frist Affliated Hospital of Xi'an Medical University from January 2018 to August 2021 for the study.The clinical data were collected and serum bilirubin and UACR were analyzed by automatic biochemical analyzer.Subjects were classified into the normal albuminuria group(n=75),microalbuminuria group(n=78)and macroalbuminuria group(n=62)based on UACR levels.The correlation between serum total bilirubin,direct bilirubin,indirect bilirubin and UACR were analyzed.Results The levels of serum total bilirubin,direct bilirubin and indirect bilirubin in microalbuminuria group and macroalbuminuria group were significantly lower than that in normal albuminuria group(all P＜0.05);the levels of total bilirubin,direct bilirubin and indirect bilirubin in macroalbuminuria group were significantly lower than those in microalbuminuria group(all P＜0.05).Binary logistic regression analysis showed that total bilirubin(OR=0.874,95％CI:0.814-0.939),direct bilirubin(OR=0.772,95％CI:0.637-0.935)and indirect bilirubin(OR=0.874,95％CI:0.806-0.949)were significant negatively correlated with UACR.Stratified analysis revealed that the levels of total bilirubin were negatively correlated with UACR in men(OR=0.80,95％CI:0.78-0.93)and women(OR=0.83,95％CI:0.70-0.97)with diabetic foot ulcer.In diabetic foot ulcer with Wagner grade 2-3(OR=0.86,95％CI:0.78-0.96)and grade 4-5(OR=0.78,95％CI:0.64-0.96),the levels of total bilirubin were negatively associated with UACR,but there were no significant correlated between total bilirubin and UACR in diabetic foot ulcer with Wagner grade 0-1.Smooth curve fitting based on threshold saturation showed when total bilirubin＜11.8 μmol/L,UACR level decreased 128.9 mg/g for every 1 μmol/L increase in total bilirubin;when direct bilirubin＜2.3 μmol/L,UACR level decreased 641.2 mg/g for every 1 μmol/L increase in direct bilirubin.Conclusion The serum bilirubin level in patients with diabetic foot ulcer was negatively correlated with UACR,which may be a protective factor of UACR and reflect the progress of UACR.
Diabetic foot ulcerBilirubinUrinary microalbumin/creatinine ratio
万方数据
维普
