Relationship between Serum Indirect Bilirubin Level and Insulin Sensitivity: Results from Two Independent Cohorts of Obese Patients with Impaired Glucose Regulation and Type 2 Diabetes Mellitus in China

作者：Fan Zhang, Wei Guan, Zhenzhen Fu, Li Zhou, Wen Guo, Yizhe Ma, Yingyun Gong, Wanzi Jiang, Hui Liang, Hongwen Zhou · 发表于：International Journal of Endocrinology · 年份：2020 · DOI：10.1155/2020/5681296 · 被引用次数：23 · 研究领域：Heme Oxygenase-1 and Carbon Monoxide、Neonatal Health and Biochemistry、Diabetes and associated disorders

Background . Serum bilirubin is an endogenous antioxidant that has protective effects against obesity-related metabolic diseases. Objectives . This study aimed to evaluate the characteristics of total bilirubin (TBIL), direct bilirubin (DBIL), and indirect bilirubin (IBIL) and their relationships with insulin sensitivity in obese patients with impaired glucose regulation and type 2 diabetes mellitus (IGR/T2DM) in China. Patients and Methods . Cohort 1 comprised obese patients ( n = 71) was divided into the IGR/T2DM group ( n = 38, obesity with IGR/T2DM) and control group ( n = 33, obesity without IGR/T2DM). Insulin sensitivity was evaluated using the hyperinsulinemic-euglycemic clamp technique (HEC) with glucose disposal rate (GDR, M value). Cohort 2 comprised obese patients with IGR/T2DM who underwent metabolic surgery ( n = 109) as complementary to cohort 1. Insulin sensitivity was evaluated with the Matsuda Index and homeostatic model assessment of insulin sensitivity (HOMA-IS). Results . In cohort 1, TBIL, DBIL, and IBIL were higher within the physiological range in the IGR/T2DM group compared with the control group; IBIL was positively correlated with M value ( r = 0.342, p = 0.044 ) in the IGR/T2DM group, and multivariate logistic regression showed that IBIL might be independent protective factors against insulin resistance (odds ratio (OR) = 0.602; 95% confidence interval (CI): 0.413–0.878; p = 0.008 ). In cohort 2, at 1 month after metabolic surgery, serum b...