{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T11:53:25Z","timestamp":1778500405316,"version":"3.51.4"},"reference-count":46,"publisher":"Baishideng Publishing Group Inc.","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Diabetes"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Diabetic retinopathy (DR) is a major cause of visual impairment and blindness. However, the current DR biomarkers are insufficient for accurately predicting its onset.<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To identify a novel marker for predicting the risk of developing DR in patients with type 2 diabetes mellitus (T2DM).<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>We conducted a cross-sectional study involving 6993 hospitalized T2DM patients between 2013 and 2020. Patients were divided into two groups: The DR group and the non-DR group. Data were analyzed using univariate, correlation, multivariate, subgroup, and receiver operating characteristic curve analyses.<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>Total bilirubin, indirect bilirubin (IBIL), and direct bilirubin were negatively correlated with the risk of developing DR (P  &lt; 0.001). Moreover, these three factors were all positively correlated with clinical indicators related to DR, including the estimated glomerular filtration rate, the albumin\/creatinine ratio, and the 1,25-dihydroxyvitamin D3 level (P  &lt; 0.001). After adjusting for multiple variables, greater IBIL levels remained independently associated with a lower risk of developing DR (odds ratio = 0.500; 95% confidence interval: 0.363-0.686; P  &lt; 0.001). The optimal IBIL cutoff point for predicting the risk of DR in male patients with elevated diastolic blood pressure was 0.655 \u03bcmol\/dL (area under the curve = 0.662).<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>These findings suggest that IBIL could be a valuable biomarker for predicting DR risk, offering a noninvasive, cost-effective, and readily available clinical tool for the early identification of high-risk patients. Future multicenter and longitudinal studies are warranted to validate these findings and further explore the biological mechanisms underlying the protective role of IBIL in DR.<\/jats:p>","DOI":"10.4239\/wjd.v16.i9.110590","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T13:00:38Z","timestamp":1757509238000},"source":"Crossref","is-referenced-by-count":4,"title":["Indirect bilirubin is inversely associated with diabetic retinopathy risk and is a potential predictive 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