Serum bilirubin as a biomarker of oxidative stress in children with type 1 diabetes mellitus: An observational study

This study aims to explore whether bilirubin can act as a biomarker of oxidative stress in type 1 diabetes mellitus (T1DM) by analyzing the serum bilirubin levels and possible influencing factors in different disease states and durations in children with T1DM. This is a retrospective study. The medical records of 1652 inpatients with T1DM and 101 healthy children in Shanxi Provincial Children's Hospital from 2014 to 2023 were collected and divided into different subgroups. The relevant indices in different disease states and durations in the T1DM group were statistically analyzed, particularly the serum bilirubin levels and possible influencing factors. Compared to children without diabetic ketoacidosis (DKA)/diabetic ketosis (DK), children with DKA/DK exhibited higher random blood glucose (RBG), HbA1C, total bilirubin (TBil), and indirect bilirubin (IBil) (P < .05). Compared to the control group, the levels of TBil and IBil in the newly-diagnosed and established T1DM children were statistically significantly higher (P < .05). Compared to newly-diagnosed T1DM children, serum TBil and IBil levels were statistically significantly lower in the established T1DM group and subgroups with different disease durations (P < .05). TBil and IBil were correlated with the status of blood glucose control and can be reflected by RBG, HbA1C, and DKA/DK (P < .05), but had no correlation was observed with disease duration (P > .05). Serum bilirubin possesses the potential to be a biomarker of oxidative stress in T1DM children.