Abstract: Objective To investigate the relationship between serum bilirubin, bile acid and diabetic retinopathy(DR) in the elderly patients with type 2 diabetes mellitus(T2DM). Methods A total of 363 elderly patients with T2DM in our hospital from January 2018 to December 2019 were retrospectively collected, 153 cases of them presenting with diabetic retinopathy(PDR), 210 cases of them presenting with non-diabetic retinopathy (NDR) with course over 10 years. The basic clinical data, serum levels of bilirubin and bile acid of the two groups were compared. All the patients were divided into three groups according to the serum levels of bilirubin or bile acid (low, medium and high level group), and the incidence rate of PDR in each group were compared. Multivariate Logistic regression analysis was used to analyze the risk factors of DR. Result The serum levels of bilirubin and bile acid in the NDR patients were significantly higher than those in the PDR patients(P<0.05); while the levels of cholesterol, low-density lipoprotein cholesterol(LDL-C) and urinary albumin excretion rate(UAER) were significantly lower (P<0.05). The incidence rate of PDR was decreased while the serum levels of bilirubin and bile acid increased. According to the Logistic regression analysis, serum bilirubin and bile acid were protecting factors of DR, while LDL-C and UAER>20 μg/min were risk factors. Conclusions In the elderly patients with T2DM, serum bilirubin and bile acid show particular relationships with DR, which may to be potential protecting factors.

Key words: aged, type 2 diabetes mellitus, diabetic retinopathy, bilirubin, bile acid