Association of Serum Total Bilirubin to Cholesterol Ratio With Progression of Chronic Kidney Disease in Patients With Type 2 Diabetes: A Retrospective Cohort Study

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2025-05-13 DOI:10.1111/1753-0407.70097

Yanyan Chen, Shanshan Wang, Hang Guo, Fei Han, Bei Sun, Nan Li, Hongxi Yang, Liming Chen

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Abstract

Aim

To explore the influence of the serum total bilirubin to total cholesterol (TBIL/TC) ratio on the progression of chronic kidney disease (CKD) in people with type 2 diabetes.

Materials and Methods

The present retrospective discovery cohort investigated 4282 patients. The exposure was baseline TBIL/TC ratio. The outcome was the first time to progressing CKD, defined by a drop in the estimated glomerular filtration rate (eGFR) category, along with a reduction in eGFR of at least 25% compared to the baseline value. Hazard ratios (HRs) for CKD progression were evaluated based on the Cox proportional hazards approach. Dose–response relationships were conducted using Restricted Cubic Splines (RCS). Additionally, 758 patients were enrolled as an independent validation cohort.

Results

During a median observation period of 2.4 years (interquartile range 1.3–3.8 years) within the discovery cohort, 522 individuals showed progression in CKD. The analysis revealed a negative association between the TBIL/TC ratio and the risk of CKD progression, with an adjusted HR of 0.17 and a 95% CI ranging from 0.07 to 0.41. After adjusting for confounding variables, the HRs for the second, third, and fourth quartiles of the TBIL/TC ratio were recorded at 0.61 (95% CI 0.48, 0.78), 0.55 (95% CI 0.42, 0.72), and 0.55 (95% CI 0.41, 0.74), respectively. Analysis with RCS indicated an optimal TBIL/TC ratio threshold of 0.25%. Similar results were also observed in the validation cohort.

Conclusions

A higher TBIL/TC ratio was significantly associated with a reduced risk of CKD progression in patients with type 2 diabetes.

Abstract Image

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血清总胆红素/胆固醇比值与2型糖尿病患者慢性肾病进展的关系：一项回顾性队列研究

目的探讨血清总胆红素/总胆固醇（TBIL/TC）比值对2型糖尿病患者慢性肾脏疾病（CKD）进展的影响。材料与方法本回顾性发现队列共调查4282例患者。暴露为基线TBIL/TC比值。结果是首次进展性CKD，定义为肾小球滤过率（eGFR）类别的估计下降，与基线值相比，eGFR降低至少25%。基于Cox比例风险法评估CKD进展的风险比（hr）。剂量-反应关系采用限制三次样条（RCS）进行。此外，758名患者被纳入独立验证队列。结果：在发现队列的中位观察期为2.4年（四分位数范围为1.3-3.8年），522人表现出CKD进展。分析显示TBIL/TC比值与CKD进展风险呈负相关，调整后的HR为0.17,95% CI范围为0.07至0.41。在调整混杂变量后，TBIL/TC比率的第二、第三和第四四分位数的hr分别记录为0.61 （95% CI 0.48, 0.78）、0.55 （95% CI 0.42, 0.72）和0.55 （95% CI 0.41, 0.74）。RCS分析显示最佳TBIL/TC比值阈值为0.25%。在验证队列中也观察到类似的结果。结论：较高的TBIL/TC比值与2型糖尿病患者CKD进展风险降低显著相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.