Evidence map›Paper›PMID 39620335›Full record

ArticleCurrent diabetes reviews2026

An Association between Bilirubin and Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus: An Effect Modification by Nrf2 Polymorphisms.

Qiwei Fan, Shanshan Feng, Jianrong Chen, Yan Zhang, Jixiong Xu, Jiancheng Wang

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Article in Current diabetes reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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2 citing papers in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Qiwei FanDepartment of Endocrine and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Shanshan FengDepartment of Endocrine and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Jianrong ChenDepartment of Endocrine and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Yan ZhangDepartment of Endocrine and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Jixiong XuDepartment of Endocrine and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Jiancheng WangDepartment of Endocrine and Metabolism, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.

Funding

Clinical Cultivation Program of the First Affiliated Hospital of Nanchang University YFYLCYJPY202308National Natural Science Foundation of China 81460018, 82160139Science and Technology Project of the Education Department of Jiangxi Province GJJ190059
6 · The paper itself

Abstract

introductionDiabetic retinopathy (DR) is a persistent microvascular complication associated with diabetes, and it constitutes a significant cause of visual impairment and blindness.

aimsThis study aimed to assess the correlation between serum bilirubin levels and the prevalence of DR in patients diagnosed with type 2 diabetes mellitus (T2DM). Additionally, we sought to establish whether the polymorphisms of Nuclear Factor E2-Related Factor 2 (Nrf2) might modify this relationship.

methodsA cross-sectional study was undertaken in Jiangxi, China, from May, 2012 to December, 2014. Serum bilirubin levels were assessed in 558 subjects, and the correlation between bilirubin and DR was analyzed using generalized linear models with a logit link. The study utilized odds ratios (OR) and 95% confidence intervals (CI) to evaluate the relationship, both with and without the consideration of clinical risk factors. RESULTS AND DISCUSSION: There was a significant inverse association between serum total bilirubin (TBiL) and the risk of DR (per 1-μmol/L increment; OR, 0.89; 95% CI: 0.84-0.94). Accordingly, when TBiL was categorized into tertiles, individuals in tertiles 2 and 3 exhibited significantly lower risks of DR compared to those in tertile 1. The OR for these tertiles was 0.54 (95% CI: 0.34-0.87) and 0.31 (95% CI: 0.19-0.52), respectively. Moreover, a stronger inverse relationship between TBiL and DR was observed in individuals carrying the CC and AC genotypes compared to those with the AA genotype. The OR for individuals with the CC/AC genotype was 0.87 (95% CI: 0.82, 0.92), while that for the AA genotype was 1.17 (95% CI: 0.95, 1.45). This difference was statistically significant (p for interaction = 0.001).

conclusionThere was a significant inverse association between bilirubin and DR in participants with CC or AC genotype. However, this inverse association was not seen in AA genotype participants.

Indexed as

BilirubinDiabetes Mellitus, Type 2Diabetic RetinopathyNF-E2-Related Factor 2AgedChinaCross-Sectional StudiesFemaleGenetic Predisposition to DiseaseHumansMaleMiddle AgedPolymorphism, GeneticPolymorphism, Single NucleotidePrevalenceRisk FactorsBilirubinNFE2L2 protein, humanNF-E2-Related Factor 2antioxidantdiabetic mellitusdiabetic retinopathyNrf2 polymorphismsSerum bilirubintotal bilirubin

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.