To the Editor: There is limited human evidence indicating beneficial effects of antioxidants on diabetic vascular complications.1 Although bilirubin has been recognized as an important endogenous antioxidant,2 whether hyperbilirubinemia affects the development of diabetic vascular complications is unknown. We therefore compared the prevalence of vascular complications in patients with diabetes and Gilbert syndrome (a congenital hyperbilirubinemia) and in patients with diabetes without Gilbert syndrome.
Inoguchi T, Sasaki S, Kobayashi K, Takayanagi R, Yamada T. Relationship Between Gilbert Syndrome and Prevalence of Vascular Complications in Patients With Diabetes. JAMA. 2007;298(12):1396–1400. doi:10.1001/jama.298.12.1398-b