[Increase of conjugated bilirubin in diabetics]

Three hundred patients were studied: 150 had NIDDM and the other 150 were non diabetics. Serum glucose and total and fractionated bilirrubin were measured in samples taken after night fasting. The mean glucose in the NIDDM group was 180.4 +/- 17.9 mg/dL (+/- SD) and 82.7 +/- 4.4 mg/dL in the non diabetic (p < 0.001). The levels of total bilirrubin were similar in both groups (0.84 +/- 0.04 vs 0.81 +/- 0.02 mg/dL, p > 0.40) but there were group differences in direct bilirrubin (NIDDM 0.52 +/- 0.03 vs 0.20 +/- 0.01 mg/dL, p < 0.001) and in indirect bilirrubin (NIDDM 0.32 +/- 0.03 vs 0.61 +/- 0.02 mg/dL, p < 0.001). Thus, 62% of the circulating bilirrubin was conjugated in the diabetics and only 25% in the non diabetics. We believe that at least part of the UDP-glucose pathway is altered in NIDDM and leads to an increase in the levels of glucouronic acid and, in turn, may cause a rise in direct bilirrubin at the expense of indirect bilirrubin.