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To the Editor: There is limited human evidence indicating beneficial effects of antioxidants on diabetic vascular complications.¹ Although bilirubin has been recognized as an important endogenous antioxidant,² whether hyperbilirubinemia affects the development of diabetic vascular complications is unknown. We therefore compared the prevalence of vascular complications in patients with diabetes and Gilbert syndrome (a congenital hyperbilirubinemia) and in patients with diabetes without Gilbert syndrome.

Methods

Screening of 5080 patients with diabetes who visited Kyushu University Hospital and 12 other hospitals and clinics in the Kyushu District of Japan from April to June 2006 yielded 96 consecutive patients with Gilbert syndrome, all of whom were enrolled. Determination of Gilbert syndrome was based on the presence of unconjugated bilirubin-dominant hyperbilirubinemia (serum bilirubin level >1.2 mg/dL; to convert to µmol/L, multiply by 17.104) for 3 or more months in the absence of hemolytic disease and/or hepatic dysfunction.³ Patients with diabetes for less than 5 . . . [Full Text of this Article]

Toyoshi Inoguchi, MD
toyoshi@intmed3.med.kyushu-u.ac.jp

Shuji Sasaki, MD; Kunihisa Kobayashi, MD; Ryoichi Takayanagi, MD
Department of Medicine and Bioregulatory Science

Tomomi Yamada, PhD
Department of Medical Information Science
Faculty of Medical Sciences
Kyusyu University
Fukuoka, Japan