Zhang Dandan, Hou Wolin, Liu Fang, Yin Jun, Lu Wei, Li Ming, Zheng Taishan, Lu Fengdi, Bao Yuqian, Jia Weiping
Department of Endocrinology and Metabolism, Shanghai Jiaotong University Affiliated Sixth People's Hospital , Shanghai, China .
Diabetes Technol Ther. 2015 Feb;17(2):72-9. doi: 10.1089/dia.2014.0176. Epub 2014 Dec 30.
This study was designed to clarify the influence of metformin on serum carbohydrate antigen 199 (CA199) levels and its associated factors in Chinese type 2 diabetes mellitus (T2DM) patients.
In total, 1,253 T2DM patients were enrolled, including a non-metformin group (n = 616), a short-term metformin group (at least 1 week to 2 years; n=325), and a long-term metformin group (≥ 2 years; n = 312). Their clinical and biochemical characteristics were collected and compared. After 1 year, the biochemical parameters were re-examined in 296 patients. Sex hormones were determined, and associations between CA199 and other variables were assessed.
At baseline, the incidence of abnormal CA199 levels was 14.7%, 8.9%, and 4.7% in the non-metformin, short-term metformin, and long-term metformin groups, respectively. CA199 levels in females were significantly higher than in males (P < 0.01) and decreased significantly with the time of taking metformin (25.60 ± 13.68 U/mL in non-metformin controls vs. 17.62 ± 10.87 U/mL in the short-term group vs. 10.54 ± 8.14 U/mL in the long-term group; P = 0.000). The correlation and multiple stepwise regression analysis revealed that glycosylated hemoglobin, metformin, gender, total cholesterol, and follicle-stimulating hormone were independent impact factors on CA199 concentrations (all P < 0.05). Binary logistic regression revealed that the risk of abnormal CA199 concentrations of the total population with short-term metformin or long-term metformin treatment decreased 11% (odds ratio = 0.89; P = 0.001) and 30% (odds ratio = 0.70; P = 0.000), respectively, at baseline. After a 1-year follow-up, the incidence of high CA199 level decreased in both the short-term and the long-term metformin group compared with that of controls (P < 0.05). The extent of CA199 decrease in the long-term metformin group was the greatest (-17% vs. -4.9% in the short-term group vs. 3% in controls, P = 0.000), and the group's risk of high blood CA199 level was reduced 67% (odds ratio = 0.33; P = 0.023). The reduction in women was more apparent than that in men (-18% vs. -5%, P = 0.000).
Metformin therapy reduced the CA199 level in Chinese T2DM patients, and its greatest decrease occurred in women with longer therapeutic time.
本研究旨在阐明二甲双胍对中国2型糖尿病（T2DM）患者血清糖类抗原199（CA199）水平的影响及其相关因素。
共纳入1253例T2DM患者，包括非二甲双胍组（n = 616）、短期二甲双胍组（至少1周至2年；n = 325）和长期二甲双胍组（≥2年；n = 312）。收集并比较他们的临床和生化特征。1年后，对296例患者重新检测生化参数。测定性激素，并评估CA199与其他变量之间的关联。
基线时，非二甲双胍组、短期二甲双胍组和长期二甲双胍组CA199水平异常的发生率分别为14.7%、8.9%和4.7%。女性的CA199水平显著高于男性（P < 0.01），且随着服用二甲双胍时间的延长而显著降低（非二甲双胍对照组为25.60±±13.68 U/mL，短期组为17.62±±10.87 U/mL，长期组为10.54±±8.14 U/mL；P = 0.000）。相关性和多元逐步回归分析显示，糖化血红蛋白、二甲双胍、性别、总胆固醇和促卵泡激素是影响CA199浓度的独立因素（均P < 0.05）。二元logistic回归显示，在基线时，短期或长期接受二甲双胍治疗的总体人群中CA199浓度异常的风险分别降低了11%（比值比 = 0.89；P = 0.001）和30%（比值比 = 0.70；P = 0.000）。经过1年的随访，与对照组相比，短期和长期二甲双胍组中CA199水平升高的发生率均降低（P < 0.05）。长期二甲双胍组中CA199降低的幅度最大（-17%，短期组为-4.9%，对照组为3%，P = 0.000），该组血CA199水平升高的风险降低了67%（比值比 = 0.33；P = 0.023）。女性的降低比男性更明显（-18%对-5%，P = 0.000）。
二甲双胍治疗可降低中国T2DM患者的CA199水平，且在治疗时间较长的女性中降低幅度最大。
