目的 观察2型糖尿病患者血清肿瘤标志物CA19-9、CEA水平,分析2型糖尿病患者糖代谢紊乱中肿瘤标志物良性升高的特点及相关因素.方法 选择397例2型糖尿病患者和390名正常体检者,比较血清肿瘤标志物CA19-9、CEA水平,并分析其特点和相关因素.结果 (1)糖尿病组CA19-9和CEA水平较正常组明显升高(P＜0.01);(2)HbA1c分亚组研究显示CA19-9、CEA水平均为HbA1c高值亚组＞中值亚组＞低值亚组(P＜0.05或0.01);(3)年龄分亚组研究发现糖尿病组CEA水平＞61岁亚组高于46~60岁亚组高于＜45岁亚组(P＜0.05),CA19-9水平在2型糖尿病患者不同年龄亚组间无统计学差异;(4)性别分亚组研究显示糖尿病女性亚组CA19-9水平高于男性亚组(P＜0.01),CEA组男女亚组间无统计学差异;(5)相关及回归分析显示2型糖尿病患者血清CA19-9、CEA与HbA1c呈正相关,HbA1c是糖尿病患者CA19-9和CEA增高的独立危险因素.结论 在糖尿病人群中,血清CA19-9、CEA等肿瘤标志物可以有低水平的良性升高,与HbA1c存在一定相关性,在糖尿病人群中应动态观察血清肿瘤标志物水平的变化.%Objective To investigate the variation of serum CA19-9 and CEA levels in type 2 diabetic patients and its related factors. Methods Three hundred and ninety seven type 2 diabetic patients and 390 normal subjects were enrolled in the study. Serum CA19-9 and CEA levels were measured and its related factors were analyzed. Results Serum CA19-9 and CEA level were higher in diabetic patients than those in normal controls (P<0.01). Serum CA19-9 and CEA levels were higher in high-HbA1c subgroup than those in intermediate- and low-HbA1c subgroups (P<0.05 or 0.01). CEA levels in diabetic patients over 61 y were higher than those in patients aged 45-60y and <45y (P<0.05), however, such correlation was not observed in CA19-9 levels. Female diabetic patients had higher CA19-9 level than male patients (P<0.01), but there was no gender difference in CEA level. Serum CEA and CA19-9 levels of diabetic patients were positively correlated with HbA1c levels. Multivariate logistic regression analysis showed that HbA1c was an independent risk factor for both CA19-9 and CEA elevation in diabetic patients. Conclusion Nonmalignant elevation of CA19-9 and CEA can be observed in diabetic patients, which was positively related with HbA1c. Serum tumor biomarkers should be follow up dynamically in diabetic patients, especially after the restoration of metabolic disorder.
展开▼
