INCREASED CONJUGATED BILIRUBIN IN NON-INS ULIN-DEPENDENT DIABETES

Three hundred patients were studied: 150 had NIDDM and the other 150 w ere 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 m g/dL in the non diabetic (p < 0.001). The levels of total bilirrubin w ere 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 0.5 2 +/- 0.03 vs 0.20 +/- 0.01 mg/dL, p < 0.001) and in indirect bilirrub in (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-g lucose pathway is altered in NIDDM and leads to an increase in the lev els of glucouronic acid and, in turn, may cause a rise in direct bilir rubin at the expense of indirect bilirrubin.