2型糖尿病患者血清CA19-9、CA125水平及其相关因素分析

Change of serum CA19-9，CA125 levels and its related factorsin patients with type 2 diabetes mellitus

摘要:

目的：观察分析2型糖尿病（type 2 diabetes mellitus，T2DM）患者血清糖类抗原19-9（carbohydrate antigen19-9，CA19-9）、糖类抗原125（carbohydrate antigen125，CA125）水平及其影响因素。方法：选取117例T2DM患者和132例健康体检者，计量资料采用t检验、非参数检验，计数资料采用?字2检验，比较糖、脂、蛋白指标及血清CA19-9、CA125水平。T2DM患者再按糖化血红蛋白（haemoglobin A1c，HbA1c）水平、并发症情况分组比较CA19-9和CA125水平；观察治疗前后CA19-9或CA125异常升高T2DM患者糖类抗原水平变化。结果：（1）与正常人群相比，T2DM患者糖脂组份和CA19-9、CA125水平均明显升高，白蛋白水平明显降低（均P＜0.05）；（2）与HbA1c≤7.5%T2DM患者（n=34）比，HbA1c ＞7.5% T2DM患者（n=83）的糖代谢指标及CA19-9、CA125水平均明显升高（均P＜0.01）；（3）与无并发症者（n=50）和伴慢性并发症者（n=51）相比，伴急性并发症者（n=16）糖代谢指标及CA19-9、CA125水平均明显升高（均P＜0.05）；（4）与入院时相比，治疗后CA19-9或CA125异常升高T2DM患者糖类抗原均显著降低（均P＜0.05）；（5）相关分析显示，T2DM患者中血糖（r值分别为0.353、0.269，P值均＜0.01）、HbA1c（r值分别为0.320、0.325，P值均＜0.01）、糖化血清白蛋白（r值分别为0.307、0.324，P值均＜0.01）、总胆固醇（r值分别为0.215、0.359，P值均＜0.05）与CA19-9、CA125升高呈正相关，白蛋白（r值分别为-0.296、0.359，P值均＜0.05）与CA19-9、CA125升高呈负相关。结论：T2DM患者不仅存在糖脂代谢紊乱，也存在蛋白代谢异常；血糖控制越差时，CA19-9或CA125水平升高更明显；血糖控制好转后，CA19-9或CA125水平将明显降低；糖脂蛋白代谢紊乱可能是影响CA19-9或CA125升高的因素。

Abstract:

Objective：To investigate the association between serum CA19-9，CA125 levels and its related factors in T2DM patients. Methods：Totally 117 T2DM patients and 132 healthy subjects who had medical checkups were recruited to compare metabolic in－dices including blood glucose，lipids and protein as well as serum CA19-9 and CA125 levels. The change in CA19-9 and CA125 lev－els before and after treatment was observed. Results：（1）Statistically significant differences were found between normal controls and T2DM patients in serum CA19-9，CA125 levels and metabolic components including glucose，lipids and protein（all P＜0.05）. （2）There were statistical differences in serum glucose，CA19-9 and CA125 levels in T2DM patients with a HbA1c＞7.5% when compared with those with a HbA1c≤7.5%（all P＜0.05）. （3）When compared with patients with no complication and those with chronic compli－cations，T2DM patients with acute complications had statistically different serum levels of glucose，CA19-9 and CA125（all P＜0.05）. （4）Carbohydrate antigens of T2DM patients with abnormal CA19-9 or CA125 were significantly lower after treatment than before treatment（all P＜0.05）. （5）Correlation analysis revealed that glucose，HbA1c and total cholesterol were positively correlated with CA19-9，CA125 levels in T2DM patients. Serum albumin was negative correlated with CA19-9 and CA125 levels in T2DM patients. Conclusion：T2DM patients exists not only glucose and lipid metabolism disorders，but also disorders of protein metabolism. More evi－dent increase in CA19-9 and CA125 levels will arise if the T2DM patient has poorer glycemic control. With the improvement of glycemic control，CA19-9 and CA125 levels will decrease. The change in serum and CA125 levels in T2DM patients is likely to be associated with disorders of glucose，lipid and pro－tein metabolism.