2型糖尿病患者血清CA19-9的检测意义及其与血糖水平的关系
Clinical significance of serum carbohydrate antigen 19-9 and its relationship with blood glucose in patients with type 2 diabetes
目的 探讨2型糖尿病(T2DM)患者糖链抗原(CA) 19-9与血糖水平的关系. 方法 选取784例T2DM患者和197例健康体检者,记录年龄、病程、体质指数(BMI)、收缩压、舒张压、空腹血糖(FBG)、餐后2h血糖(PBG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿酸、C肽、CA19-9等指标.按不同HbA1c水平及CA19-9水平分组,同时分析血清CA 19-9与上述指标的相关关系. 结果 与对照组比较,T2DM患者CA19-9水平增高[(22.08±14.94) U/ml与(10.24±6.31) U/ml,t=12.10,P=0.000].不同HbA1c水平的T2DM患者收缩压、舒张压、FBG、PBG、C肽、TC、TG、LDL-C、血尿酸水平均高于对照组,HDL C水平低于对照组,差异具有统计学意义(均P<0.05).随着HbA1c的增高,T2DM患者中的FBG、PBG及CA19-9水平增高,HbA1c≤6.5%者、6.5%<HbA1c≤7.5%者和HbA1c>7.5%者FBG分别为(6.36±3.70) mmol/L、(9.01±4.01) mmol/L、(11.96±4.73) mmol/L,PBG分别为(9.69±3.21) mmol/L、(12.18±5.54) mmol/L、(15.27±5.08) mmol/L,CA19-9水平分别为(14.33±11.72) U/ml、(18.76±14.39) U/ml、(25.96±17.52) U/ml(F=14.38、12.94、17.25,均P<0.05).CA19 9增高组的FBG、HbA1c水平及胰腺癌发生率均明显高于CA19-9正常组[(11.71±5.48) mmol/L与(9.78±4.38) mmol/L,(7.49±4.12)%与(6.33±3.70)%,7.8%与0%,t=-3.51、-2.55,x2 =83.58,均P<0.05].Pearson相关分析显示T2DM组的CA19 9水平与HbA1c(r=0.281,P=0.007)、FBG(r=0.134,P=0.040)呈正相关;多元logistic回归分析显示FBG、HbA1c与T2DM患者CA19-9升高有关(OR=1.226、1.582,P=0.019、0.026). 结论 T2DM患者血清CA19 9水平显著高于健康人群,且与血糖控制水平相关.
更多Objective To study the relationship between serum carbohydrate antigen 19-9 (CA19-9) and blood glucose level in patients with type 2 diabetes (T2DM).Methods Totally 784 T2DM patients and 197 healthy controls were enrolled in this study.Age,duration,body mass index (BMI),systolic blood pressure (SBP),diastolic blood pressure (DBP),levels of fasting blood glucose (FBG),postprandial blood glucose (PBG),hemoglobin A1c (HbA1c),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),blood uric acid,C peptide and CA 19-9 were recorded.Patients were divided into different groups according to the levels of HbA1 c and CA 19-9.The relationship between CA19-9 and influencing factors was analyzed.Results CA19-9 level was increased in T2DM patients compared with healthy controls [(22.08±14.94) U/mlvs.(10.24±6.31) U/ml,t=12.10,P<0.001].The levels of SBP,DBP,FBG,PBG,C peptide,TC,TG,LDL and UA were higher and HDL C level was lower in T2DM patients than in healthy controls (all P<0.05).The levels of FBG,PBG and CA19-9 were increased along with the increase of HbA1c level in T2MD patients with HbA1c level under 6.5%,T2MD patients with HbA1c level from 6.5% to 7.5%,T2MD patients with HbA1c level over 7.5% [FBG:(6.36±3.70) mmol/L,(9.01±4.01) mmol/L,(11.96±4.73) mmol/L;PBG:(9.69±3.21) mmol/L,(12.18±5.54) mmol/L,(15.27±5.08) mmol/L; CA19 9 (14.33±11.72) U/ml,(18.76±14.39) U/ml,(25.96±17.52) U/ml,respectively,all P<0.05].The levels of FBG,HbA1c and pancreatic cancer incidence were higher in patients with elevated CA19-9 than with normal CA19-9 [(11.71±5.48)mmol/L vs.(9.78±4.38)mmol/L,(7.49±4.12)% vs.(6.33±3.70)%,0% vs.7.8%,t=-3.51,2.55,x2=83.58,allP<0.05].Pearson correlation analysis showed that CA19-9 level was positively correlated with the levels of HbA 1 c and FBG in T2DM patients (r=0.281,0.134,both P<0.05).Multiple Logistic regression analysis showed that the levels of FBG and HbA1c were correlated with the increase of CA19 9 in T2DM patients(OR=0.801,0.947,P=0.019,0.026).Conclusions Serum CA19-9 level is significantly increased in T2DM patients compared with the healthy people.Serum CA19-9 level is correlated with blood glucose control.
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