The Role of Risk Factors (Onset - Hospitalization, Onset - Surgery, Increase in Pulse, Systolic Blood Pressure) on Death in Gastric Perforation

ABSTRACT Introduction. Gastric perforation is the second most common complication due to peptic ulcer after bleeding where the risk of mortality in patients who have received surgical treatment is still high. The factors that have the greatest influence on the death of the patient are old age and the time span of handling more than 24 hours. This study aims to determine the relationship between risk factors (onset - hospitalization, onset - surgery, increased pulse, decreased systolic blood pressure) on the death of gastric perforation patients undergoing surgery at Dr. General Hospital Mohammad Hoesin Palembang. Methods: An observational analytic study with a case-control study design was carried out from August to October 2017 at the Dr. General Central Hospital Mohammad Hoesin (RSMH) Palembang. There were 90 respondents consisting of 30 sample groups with death cases and 60 sample groups with life control. The relationship between independent and dependent variables was analyzed by Chi Square test while risk factors that play a role in death in gastric perforation patients who performed surgery were analyzed with the Logistic Regression test. Data analysis uses SPSS version 18.0. Results. There was a significant relationship between increased pulse (OR = 11,227 CI95% 3,923-32,129; p = 0,000), onset - MRS (hospital admission) (OR = 4,125 CI95% 1,579-10,773; p = 0,006) and onset - surgery (OR = 3,786 CI95% 1,267-11,308; p = 0.029) on the death of a gastric perforation patient undergoing surgery. With the Logistic Regression test, an increase in pulse and onset - hospital admission was significantly related to the death of a gastric perforation patient undergoing surgery. Conclusion. It can be concluded that the increase in pulse and onset of hospital admission are risk factors that contribute to the death of gastric perforation patients who undergo surgery.

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Faktor Risiko Kematian Neonatal Di Kabupaten Timor Tengah Selatan dan Sumba Timur

Talenta Conference Series Science and Technology (ST) ◽

10.32734/st.v2i2.468 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Masrida Sinaga ◽

Keristina Br. Ginting

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Neonatal Death ◽

Low Birthweight ◽

P Value ◽

Multiple Logistic Regression ◽

Chi Square ◽

Neonatal Deaths ◽

Regression Test ◽

Logistic Regression Test

Angka Kematian Bayi (AKB) sampai saat ini masih tinggi di Indonesia, dan Provinsi Nusa Tenggara Timur (Provinsi NTT) merupakan salah satu penyumbang tingginya AKB tersebut, paling tinggi angka di Kab. Sumba Timur dan Timor Tengah Selatan. Kematian neonatal bisa terjadi karena faktor risiko pada ibu dan juga anak. Tujuan penelitian ini untuk menganalisa faktor-faktor yang berpengaruh terhadap kematian neonatal, agar dapat dikembangkan model pengendaliannya. Penelitian menggunakan desain kasus kontrol, dengan populasi adalah semua bayi baru lahir yang bersalin di dan tercatat di RSUD dan Puskesmas perawatan yang berlokasi di Kabupaten TTS dan Sumba Timur pada tahun 2016. Sampel kasus adalah 116 kasus kematian neonatal, dan kontrol adalah 232 neonatal hidup yang merupakan tetangga terdekat kasus dengan status sosial ekonomi yang disamakan. Data dianalisis secara deskriptif dan inferensial, yakni analisis data univariabel, bivariabel (uji chi-square), dan multivariabel (uji regresi logistik ganda). Hasil penelitian menunjukkan bahwa sebagian besar kematian neonatal di Kab. TTS (81,7%) dan Kab. Sumba Timur (86,4%) terjadi pada neonatal dini, sebagian besar disebabkan asfiksia (69,2%). Faktor risiko ibu yang berhubungan dengan kematian neonatal adalah tingkat pendidikan ibu (p-value = 0,02), status gizi (anemi/KEK) (p-value = 0,000), komplikasi (p-value = 0,000), dan praktek ANC (p-value = 0,000). Semua faktor risiko anak yang diteliti yakni prematuritas (p-value = 0,000), berat bayi lahir (p-value = 0,000), asfiksia (p-value = 0,000) dan infeksi (p-value = 0,000) berhubungan dengan kematian neonatal. Sebagian besar bayi yang lahir dengan BBLR (65,5%), dengan asfiksia (69,0%) mengalami kematian neonatal. Hasil uji regresi logistik ganda menunjukkan bahwa komplikasi pada ibu (p-value = 0,000), anemi (p-value = 0,01), asfiksia (p-value = 0,000), BBLR (p-value = 0,001) dan prematuritas (p-value=0,012) merupakan faktor yang paling berisiko terhadap kematian neonatal. Perlu upaya pencegahan komplikasi pada ibu hamil/melahirkan dan peningkatan kesehatan serta status gizi ibu sebelum dan saat hamil, agar anak yang dilahirkan tidak BBLR, asfiksia, dan prematur, sehingga kematian neonatal bisa dicegah. Infant Mortality Ratio (MMR) in Indonesia remains high, and the Province of Nusa Tenggara Timur (NTT) is one of the contributors to the high IMR, the highest mortality occurred in the districts of Sumba Timur and Timor Tengah Selatan. Neonatal deaths are due to risk factors faced by women and children. The objective of this research is to analyze factors influencing neonatal death, which serve to contribute to the development of a control model. This research employs control case design, where the population consists of all neonates born (and recorded) at district hospitals and inpatient health centers located in the districts of Timor Tengah Selatan and Sumba Timur, within the year of 2016. The sample consists 116 neonatal deaths, and the control consists of 232 live neonates within the closest neighborhood, with equated socio-economic status. Data are analyzed descriptively and inferentially, through uni-variable, bi-variable (chi-square-test), and multi-variable (multiple logistic regression test) analyses. Results of this research show that most neonatal death in TTS (81.7%) and Sumba Timur (86.4%) districts occurred within the early neonates, and those are mostly caused by asphyxia (69.2%). Risk factors faced by women relevant to neonatal deaths are women’s level of education (p-value = 0.02), nutritional status (anemia/Chronic Energy Deficiency) (p-value = 0.000), complication (p-value = 0.000), and ANC practice (p-value = 0.000). All researched risk factors raced by neonates are prematurity (p-value = 0.000), birthweight (p-value = 0.000), asphyxia (p-value = 0.000) and neonatal death related infection (p-value = 0,000). Most of infants are born with Low Birthweight (65.5%), and asphyxia (69.0%) died as neonates. Results of multiple logistic regression test show that complication suffered by women (p-value = 0.000), anemia (p-value = 0.01), asphyxia (p-value = 0.000), Low Birthweight (p-value = 0.001) and prematurity (p-value = 0.012) are the highest risk factors for neonatal deaths. Prevention of complication among pregnant women/women in labor and improvement of nutritional status of women before and during pregnancy are required to ensure that infants are not born with low birthweight, asphyxia, and prematurely, which in turn prevent neonatal deaths.

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Risk Factors for Stunting Children Aged 6-59 Months In Pulau Panggung District, South Sumatera, Indonesia

BioScientia Medicina ◽

10.32539/bsm.v2i2.48 ◽

2018 ◽

Vol 2 (2) ◽

pp. 61-67

Author(s):

Prihatina Anjela ◽

Rachmat Hidayat ◽

Debby Handayanti Harahap

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Significant Relationship ◽

Female Gender ◽

Chi Square ◽

Cross Sectional ◽

Regression Test ◽

History Of ◽

Chi Square Analysis ◽

Logistic Regression Test

Background :. Stunting among children is one of the major health problems in developing countries. Globally, 45% of deaths among children are caused by malnutrition, meanwhile stunting, as one of the factors, plays an important role. Children who experience stunting can not achieve optimal growth and cognitive potential. Hence, that will have an impact on future productivity. Muara Enim district is included in one district with stunting prevalence, which is above 20%, i.e. 26.9%. This study was to identify the risk factors of stunting children in Pulau Panggung district, Muara Enim, South Sumatera. Methods: This study applied observational analytic research using cross sectional design. It was conducted on August to October 2017 at public health center in Pulau Panggung district, Muara Enim. There were 83 children who fullfilled the inclusion criteria. The relationship between risk factors and stunting was analyzed using Chi square test and Logistic Regression test was applied to identify the risk factor that play the most role to stunting. Results: 49,4% out of 83 children suffer from stunting, with a mean age of 29,37±13,69 months where the number of children stunting with male gender is 53.7% while female gender is 46.3%. Chi square analysis showed that there was a significant relationship among birth weight, birth length, mother's occupation, history of infection, exclussive breastfeeding and stunting (p< 0.05) but no significant relationship was found among sex, mother's education, maternal height and income with stunting (p> 0.05). Multivariate Logistic Regression test showed that mother's occupation and history of infection are the risk factors that contibute the most to stunting among children aged 6-59 months in Pulau Panggung district. The risk of stunting among working mothers is higher 5 times than unworking mothers and children with infection history have risk of stunting 3 times compared to children without infection history. Conclusion: Mother's occupation and infection history are risk factors that contribute the most to stunting among children at Pulau Panggung district, Muara Enim, South Sumatera.

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Relationship Between Stroke’s Risk Factors with Daily Activities Using Modified Shah Barthel Index in Chronic Stroke Patient at RSCM

Advanced Science Letters ◽

10.1166/asl.2018.12693 ◽

2018 ◽

Vol 24 (8) ◽

pp. 6225-6231

Author(s):

S Rachmayanti ◽

W Kusumaningsih

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Logistic Regression ◽

Stroke Risk ◽

Chronic Stroke ◽

Medical Rehabilitation ◽

Stroke Patients ◽

Chi Square ◽

Stroke Risk Factors ◽

The Relationship

Hypertension and diabetes mellitus are the most common risk factors of stroke.The study aimed to determine the relationship between stroke risk factors, hypertension and diabetes mellitus, with dependency of chronic stroke patients in Department of Medical Rehabilitation RSCM. The study is conducted by using the analytical observational cross-sectional study. The samples used in this study were 44 respondents selected by quota sampling method. The relationship between variabels was analyzed by bivariate test Chi-Square and multivariate analysis: Logistic Regression. Based on Chi-Square test, relationship between MSBI scoring with hypertension and diabetes mellitus as stroke risk factors, sequentiallly p = 0,122 and p = 0,002. Furthermore, Logistic Regression test suggested that hypertension and diabetes mellitus as stroke risk factors related to MSBI scoring, respectively; hypertension p = 0,076 (OR 4,076; CI95 0,861–19,297) and diabetes mellitus p = 0,007 (OR 22,690; CI95 2,332–220,722). Discussion: Diabetes mellitus is the most prominent risk factor in severe dependecy of chronic stroke patients.

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ASSOCIATION BETWEEN EMOTIONAL DEVELOPMENT AND BULLYING BEHAVIOR IN CHILDREN AT THE ELEMENTARY SCHOOL NO 7, BANYUASIN, PRAJIN, PALEMBANG

Belitung Nursing Journal ◽

10.33546/bnj.115 ◽

2017 ◽

Vol 3 (5) ◽

pp. 585-594

Author(s):

Sri Tirtayanti ◽

Intansari Nurjannah ◽

Lely Lusmilasari

Keyword(s):

Elementary School ◽

Logistic Regression ◽

Peer Influence ◽

Emotional Development ◽

School Bullying ◽

Chi Square ◽

Regression Test ◽

Chi Square Test ◽

Bullying Behavior ◽

Logistic Regression Test

Background: Bullying is a form of repetitive persecution both on physical and emotional aggressions and potentially causing mental and physical disorders on perpetrators and victims. There are various factors that may affect a child to behave as bullies. These are important factors to be identified as one of prevention effort to stop bullying behavior on children. Objective: This research aims to identify the association between emotional development and bullying behavior in children at the Elementary School No 7, Banyuasin Prajin, Palembang.Methods: This was a correlation descriptive using a cross sectional design. This research has been conducted on November 21, until December 1, 2016 involving 85 children as respondents. The instruments used for this research were Bar-On Emotional Quotient Inventory: Youth Version, school-bullying questionnaire, parenting style questionnaire and peer influence questionnaire. Chi-square test was used for bivariate data analysis and logistic regression test for multivariate analysis.Results: Results from chi-square test showed a significant association between emotional developments and parenting with bullying behavior (ρ<0,05), but no significant correlation between peer influence and bullying behavior (ρ>0,05). Logistic regression test showed a significant relationship between parenting and bullying behavior (OR) 4,655 (95% CI: 1,292-16,774), which indicated that the uninvolved parenting potentially makes bullying behavior have a chance to increase 4,655 times higher.Conclusion: There is a significant association between emotional development and parenting with children bullying behavior.

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Abstract 146: White Blood Cell Count and Risk of Stroke in Men and Women: the European Prospective Investigation into Cancer-Norfolk Prospective Population Study

Stroke ◽

10.1161/str.43.suppl_1.a146 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Yangmei Li ◽

Xinxue Liu ◽

Robert N Luben ◽

Amanda I Adler ◽

Nicholas J Wareham ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Blood Cell ◽

Systolic Blood Pressure ◽

Men And Women ◽

History Of ◽

Wbc Count ◽

The Relationship ◽

Age And Sex ◽

Prospective Investigation

Background and Objectives: An elevated white blood cell (WBC) count has been reported to be associated with all-cause mortality and risk of cardiovascular diseases. While the relationship between leukocyte count and coronary heart disease has been well documented, evidence on the association with risk of stroke has been less consistent. The aim of this study was to investigate the relationship between WBC count and incidence of stroke in a large cohort of disease-free men and women, and to assess how far any associations might be explained by traditional risk factors for stroke. Methods: We examined the prospective association between full blood WBC count and incident stroke in 7,392 men and 9,049 women from the general population participating in the European Prospective Investigation into Cancer-Norfolk Study. Participants were aged 39-79 years, without known heart attack, stroke, and cancer at the baseline examination in 1993-1997 and were followed up for incident stroke till March 2008. Results: During the median follow-up of 12 years, 542 incident stroke cases were observed. The age- and sex- adjusted risk of incident stroke increased with the increase of WBC count. Compared to the lowest quartile of WBC count, the age- and sex- adjusted hazard ratios (HRs) and 95% CIs for stroke were 1.11 (0.86-1.45), 1.40 (1.10-1.79), and 1.65 (1.29-2.09) in the second, third, and fourth quartile, respectively. Adjusting for smoking attenuated the results, while further adjustment for socioeconomic and lifestyle risk factors changed the association very little. The association was further attenuated after adjustment for biological risk factors such as systolic blood pressure and a history of diabetes at baseline, but people with the highest quartile of WBC count still had a higher risk of stroke than those in the lowest quartile (HR 1.32, 95% CI 1.02-1.71). Every 2*10 9 /L increase in WBC count was associated with a hazard ratio of 1.14 (95% CI 1.02-1.26) for stroke in the fully-adjusted model which included age, sex, smoking status, BMI, social class, educational level, alcohol intake, physical activity, systolic blood pressure, a history of diabetes at baseline, and total serum cholesterol. Conclusions: A positive association between WBC count and stroke was observed in these middle-aged and older men and women. Adjustment for smoking attenuated the association while multivariate adjustment for other risk factors did not further change the results.

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The Investigation of Sex Differences in the Effect of Body Mass Index

International Journal of Hypertension ◽

10.1155/2019/1360328 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Xiang Xiao ◽

Weihua Wang ◽

Rina Sa ◽

Lin Qiu ◽

Feng Liu

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Body Mass Index ◽

Logistic Regression ◽

Sex Differences ◽

Multivariable Logistic Regression ◽

The Mean ◽

Prevention Of Hypertension ◽

The Relationship ◽

Different Levels

Although many researches regarding risk factors for hypertension have been reported, little information is known about the effect of BMI on the prevalence of hypertension considering sex differences. The aim of this study was to examine the sex difference in the prevalence of hypertension with the predicting indicator BMI. A total number of 6330 subjects in Shaanxi were examined using multivariable logistic regression to study the relationship between genders in different levels of BMI and prevalence of hypertension. Overall, females had a higher prevalence of hypertension than males, being 28.36% and 21.55%, respectively. The mean of blood pressure and the prevalence of hypertension increased as BMI getting larger. The result of multivariable logistic regression showed that obese and overweight males had higher risk of getting hypertension than their female counterparts. Further prevention of hypertension should be focused on obese and overweight males more than females and examining the mechanism of how sex differences influence the prevalence of hypertension.

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Hypertension Factors Analysis of the Denkeslap Kesdam V/Brawijaya Malang

JOURNAL FOR QUALITY IN PUBLIC HEALTH ◽

10.30994/jqph.v3i2.88 ◽

2020 ◽

Vol 3 (2) ◽

pp. 390-397

Author(s):

Endri Mustofa

Keyword(s):

Blood Pressure ◽

Logistic Regression ◽

Sympathetic Nerve ◽

Sympathetic Nerve Activity ◽

The Body ◽

P Value ◽

Nerve Activity ◽

Cross Sectional ◽

Regression Test ◽

Logistic Regression Test

Hypertension is a degenerative disease which is a serious problem nowadays. Hypertension is categorized as the silent disease or the silent killer because the sufferer does not know he has hypertension or does not know before checking his blood pressure. The aim of this study was to find out the factors that affected hypertension of the Indonesian Army, Denkeslap Kesdam V / Brawijaya Malang. The research was conducted on 11-14 November 2018 at DENKESLAP Kesdam V / Brawijaya Malang, Observational study design with cross sectional approach. The total population is 65 people and a sample of 56 people with a random sampling technique. Data collection of independent variables and dependent variables by means of observations and questionnaires. Data analysis using logistic regression test. Based on the results of the logistic regression test, the stress variable p value is 0.027; anxiety 0.033 and sleep pattern 0.39 at α: 0.05, the incidence of hypertension is significantly affected by stress, anxiety and sleep patterns. The dominant factors affecting hypertension are stress. Stress is a condition or condition of the body that is disturbed due to psychological stress. The relationship between stress and the incidence of hypertension occurs through sympathetic nerve activity. Increased nerves can increase blood pressure intermittently (erratic). So that prolonged stress can result in high sedentary blood pressure. Stress will increase peripheral vascular resistance and cardiac output so it will stimulate sympathetic nerve activity. Soldiers are advised to adopt a healthy lifestyle, exercise and maintain a diet, avoiding things that can become stressors so as to minimize hypertension

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Analisis Faktor-Faktor yang Memengaruhi Kualitas Hidup Penderita Talasemia Anak di RSUD Al-Ihsan Kabupaten Bandung Tahun 2019

Jurnal Integrasi Kesehatan & Sains ◽

10.29313/jiks.v2i2.5848 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Jamaluddin Kamil ◽

Tito Gunantara ◽

Yani Dewi Suryani

Keyword(s):

Quality Of Life ◽

Logistic Regression ◽

Social Function ◽

Dominant Factor ◽

Multiple Logistic Regression ◽

Chi Square ◽

Regression Test ◽

Chi Square Test ◽

Logistic Regression Test

Talasemia merupakan penyakit genetik dan kronis yang dapat menyebabkan anemia berat sehingga mengganggu kualitas hidup. Penelitian ini bertujuan untuk mengetahui gambaran dan faktor apa saja yang memengaruhi kualitas hidup penderita talasemia anak di RSUD Al- Ihsan Kabupaten Bandung tahun 2019. Subjek penelitian adalah pasien talasemia anak di RSUD Al-Ihsan Kabupaten Bandung yang memenuhi kriteria inklusi. Data diambil menggunakan teknik total sampling dengan jumlah subjek 65 orang. Desain penelitian bersifat analitik dengan rancangan potong lintang. Penelitian menggunakan alat berupa kuesioner pediatric quality of life (PedsQL) yang berisi 23 pertanyaan. Hasil analisis univariat didapatkan kualitas hidup total subjek penelitian adalah buruk dengan rerata skor 68,9. Fungsi fisik, emosi, dan sekolah buruk dengan nilai rerata skor <80. Analisis bivariat dengan chi square test didapatkan hubungan bermakna antara faktor-faktor dengan kualitas hidup dengan nilai p≤0,05. Analisis multivariat dengan multiple logistic regression test didapatkan faktor yang paling dominan memengaruhi kualitas hidup yaitu fungsi sosial dengan koefisien beta 1,823 dan nilai p=0,039. Simpulan, rerata kualitas hidup penderita talasemia anak di RSUD Al-Ihsan Kabupaten Bandung adalah buruk. Fungsi yang terganggu yaitu fungsi fisik, emosi, dan sekolah. Faktor yang paling dominan memengaruhi kualitas hidup dengan nilai tertinggi yaitu fungsi sosial. ANALYSIS OF FACTORS THAT INFLUENCE THE QUALITY OF LIFE OF CHILDREN WITH THALASSEMIA IN RSUD AL-IHSAN BANDUNG IN 2019Thalassemia is a genetic and chronic disease that can cause severe anemia that disrupts the quality of life. The purpose of this study was to determine the description and factors that influence the quality of life of children with thalassemia in RSUD Al-Ihsan Bandung in 2019. The subjects were pediatric thalassemia patients in RSUD Al-Ihsan Bandung who met the inclusion criteria. Data were taken using a total sampling technique with a total 65 subjects. This study design was analytic with cross sectional design. This study used a tool of a Pediatric Quality of Life (PedsQL) questionnaire containing 23 questions. Univariate analysis results found that the total quality of life of the study subjects was poor with a mean score of 68.9. Physical, emotional, and school functions were poor with an average score of <80. Bivariate analysis with chi square test found a significant relationship between factors with quality of life with a p value ≤0.05. Multivariate analysis with multiple logistic regression test found that the most dominant factor affecting the quality of life was social function with a beta coefficient of 1.823 (p=0.039). Conclusions, the average quality of life of children with thalassemia in RSUD Al-Ihsan in Bandung is poor. Functions that are disrupted are physical, emotional, and school functions. The most dominant factor influencing the quality of life with the highest value is social function.

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Factors Associated With A Ruptured Perineum On A Vaginal Birth At The Clinic Niar The Terrain Of The Year 2018

Window of Health Jurnal Kesehatan ◽

10.33368/woh.v0i0.184 ◽

2019 ◽

pp. 170-182

Author(s):

Putri Diah Pemiliana ◽

Irma Handayani Sarumpaet ◽

Dan Sanak Ziliwu

Keyword(s):

Vaginal Birth ◽

Vacuum Extraction ◽

Test Results ◽

Chi Square ◽

Regression Test ◽

Record Data ◽

Close Relationship ◽

Relationship Of ◽

The Relationship ◽

Logistic Regression Test

Introduction: Ruptured perineum due to pregnancy, parity, age of mother, baby weight, vacuum extraction, trauma tools and episiotomy. Based on data of the World HealthOrganization(WHO) going on 2.7 million cases of rupturperineum in the mother birthing. This figure is expected to reach 6.3 million by the year 2050. The purpose of : this research is to know the factors which Fotor associated with Ruptured Perineum At vaginal birth at the clinic Pratama Medan Tahun2018 N. Method: the research design used in this research is a survey of the analytic approach of using CrossSectional , sampling using the total populationwith the techniques of medical record data collection by using the statiscttestChi Square. Results: the research on test by Chi Square, the data obtained with the data of skunder test results statistc showed no relationship age mom with ruptured perineum with p =0.037 value (p = 0.04), the relationship of the weight of the baby with a ruptured perineum with p =0.041 value (p = 0,041) and the relationship of parity with ruptured perineum with p =0.003value (p = 0.003). at the clinic the year 2018 Pratama Medan N. Based on logistic regression test variable BBL has close relationship ruptured perineum against value of sig 0.61, the value of the Exp (B)/OR largest 2.510 meaning likely or highly influential BBL 2.510 times can cause the occurrence of ruptured the perineum. Conclusion : the results of data analysis and discussion that there is a relationship of maternal Age, Parity and infant's Weight with a Ruptured Perineum in vaginal birth.

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Relationship between serum bilirubin levels, urinary biopyrrin levels, and retinopathy in patients with diabetes

PLoS ONE ◽

10.1371/journal.pone.0243407 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0243407

Author(s):

Kana Kudo ◽

Tomoaki Inoue ◽

Noriyuki Sonoda ◽

Yoshihiro Ogawa ◽

Toyoshi Inoguchi

Keyword(s):

Blood Pressure ◽

Logistic Regression ◽

Diabetic Retinopathy ◽

Regression Analysis ◽

Systolic Blood Pressure ◽

Multivariate Regression ◽

Serum Bilirubin ◽

Multivariate Regression Analysis ◽

Patients With Diabetes ◽

The Relationship

Objective Previous reports have indicated that serum bilirubin levels may be associated with diabetic retinopathy. However, the detailed mechanism is not fully understood. In this study, we evaluated the relationship between the severity of diabetic retinopathy and various factors including bilirubin levels and factors influencing bilirubin metabolism. Methods The study participants consisted of 94 consecutive patients with diabetes mellitus admitted to Kyushu University Hospital from April 2011 to July 2012. The patients were classified into three groups: no retinopathy (NDR), simple retinopathy (SDR), and pre-proliferative or proliferative retinopathy (PDR). The relationship between the severity of retinopathy and various factors was evaluated using univariate and logistic regression analyses. In addition, multivariate regression analysis was performed to evaluate the significant determinants for bilirubin levels. Results In univariate analysis, a significant difference was found among NDR, SDR and PDR in bilirubin levels, duration of diabetes, systolic blood pressure, and macroalbuminuria. Logistic regression analysis showed that PDR was significantly associated with bilirubin levels, duration of diabetes, and systolic blood pressure (OR 0.737, 95% CI 0.570–0.952, P = 0.012; OR 1.085, 95% CI 1.024–1.149, P = 0.006; OR 1.036, 95% CI 1.011–1.062, P = 0.005, respectively). In turn, multivariate regression analysis showed that bilirubin levels were negatively associated with high-sensitivity C-reactive protein levels and PDR, but positively correlated with urinary biopyrrin levels, oxidized metabolites of bilirubin. Conclusion PDR was negatively associated with bilirubin levels. This negative association may be due to a decreased production of bilirubin rather than its increased consumption considering the positive association between bilirubin and biopyrrin levels.

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