Abstract: Objective  To explore the relationship between bilirubin level and diabetic neohropathy（DN）.Methods  A total of 525 patients with type 2 diabetes mellitus(T2DM) were selected and divided into three groups according to  urinary albumintocreatinine ratio （ACR）:  normal group（ACR in men＜2.5 mg/mmol，ACR in women＜3.5 mg/mmol）  in 299 cases；early diabetic nephropathy group （ACR in men 2.530.0 mg/mmol，ACR in women 3.530.0 mg/mmol）  in 116 cases；clinical diabetic nephropathy group （ACR＞30 mg/mmol.  Exclusions were patients with renal failure）  in 110 cases. General data and serum bilirubin level were compared and analyzed among three groups.Results  The serum total bilirubin(TBIL)，direct bilirubin and indirect bilirubin in normal group were all lower than those in early diabetic nephropathy group and normal group（P<0.05）.Logistic regression analysis showed that TBIL was a protective factor for DN.Conclusion  Serum TBIL level is negatively correlated with the progression of  DN  in T2DM patients.

Key words: diabetic nephropathies, oxidative stress, bilirubin, urinary albumintocreatinine ratio