Esteghamati Alireza, Hafezi-Nejad Nima, Zandieh Ali, Sheikhbahaei Sara, Emamzadeh-Fard Sahra, Nakhjavani Manouchehr
Clin Lab. 2014;60(3):441-7. doi: 10.7754/clin.lab.2013.121243.
CA19-9 is considered a tumor marker. Reports have suggested higher CA19-9 levels in diabetic patients even with no malignancy. Our aim was to reveal the relation of CA19-9 with glycemic control in diabetic and non-diabetic subjects. For the first time we considered diabetes as an outcome based on a cut-off where the association of CA19-9 with diabetes is considerable.
The study was carried out at an outpatient metabolism clinic. A total of 422 consecutive participants were enrolled. Subjects with prior diagnosis of any cancer, renal, endocrine, or hepatic problems were not included. Age, gender, and medications as well as weight, height, and BMI were recorded. Creatinine, fasting plasma glucose (FPG), post-prandial plasma glucose (PPPG), fasting plasma insulin, HbA1c, C-peptide, HOMA-IR, and CA 19-9 were measured.
In all, 266 (63.03%) subjects had recently been diagnosed with diabetes. CA19-9 was significantly higher in the diabetic group (16.73 +/- 13.83 vs. 11.93 +/- 11.42, p < 0.001). BMI, waist circumference, FPG, and HbA1c were higher in quartiles with greater CA19-9 levels. Number of diabetic subjects in each quartile had a stepwise increase (48%, 56%, 72%, and 77%, p < 0.01). FPG, PPPG, HbA1c, and HOMA-IR were directly correlated with CA19-9 levels independent of age, gender, and BMI. We presume the 10.83 U/mL value for CA19-9 to be the optimal cut-off in indicating diabetes status (sensitivity: 0.63, specificity: 0.55).
Otherwise normal diabetic subjects have greater CA19-9 values. CA19-9 should be interpreted with regard to diabetes status. We suggest that CA19-9 levels above 10.83 U/mL in the absence of other pathologies are in favor of glycemic impairments. CA19-9 values greater than 34.30 U/mL may accompany an 84% frequency of diabetic subjects especially in settings such as referral metabolism clinics. CA19-9 values of less than 6.46 U/mL are likely to rule out the presence of diabetes, especially while testing in general population.
CA19-9被视为一种肿瘤标志物。报告显示，即使没有恶性肿瘤，糖尿病患者的CA19-9水平也较高。我们的目的是揭示糖尿病和非糖尿病受试者中CA19-9与血糖控制之间的关系。我们首次将糖尿病视为基于CA19-9与糖尿病关联显著的临界值的一个结果。
该研究在一家门诊代谢诊所进行。共纳入422名连续的参与者。排除先前诊断患有任何癌症、肾脏、内分泌或肝脏问题的受试者。记录年龄、性别、用药情况以及体重、身高和体重指数（BMI）。测量肌酐、空腹血糖（FPG）、餐后血糖（PPPG）、空腹血浆胰岛素、糖化血红蛋白（HbA1c）、C肽、胰岛素抵抗指数（HOMA-IR）和CA19-9。
总共有266名（63.03%）受试者最近被诊断患有糖尿病。糖尿病组的CA19-9显著更高（16.73±13.83对11.93±11.42，p<0.001）。CA19-9水平较高的四分位数中的BMI、腰围、FPG和HbA1c更高。每个四分位数中的糖尿病受试者数量呈逐步增加（48%、56%、72%和77%，p<0.01）。FPG、PPPG、HbA1c和HOMA-IR与CA19-9水平直接相关，且不受年龄、性别和BMI的影响。我们推测CA19-9的10.83 U/mL值是指示糖尿病状态的最佳临界值（敏感性：0.63，特异性：0.55）。
在其他方面正常的糖尿病受试者具有更高的CA19-9值。应结合糖尿病状态来解读CA19-9。我们建议，在没有其他病变的情况下，CA19-9水平高于10.83 U/mL有利于血糖受损。CA19-9值大于34.30 U/mL时，糖尿病受试者的出现频率可能为84%，尤其是在转诊代谢诊所等环境中。CA19-9值小于6.46 U/mL可能排除糖尿病的存在，尤其是在一般人群中进行检测时。
