二甲双胍对2型糖尿病患者血清糖类抗原19-9（CA 19-9）水平的影响

The Influence of Metformin on Serum Carbohydrate Antigen 19-9 (CA 19-9) Levels in Type 2 Diabetes Mellitus Patients.

作者信息

Ankit B S, Agrawal Ritvik, Gadhwal Ajeet, Chahar Chitresh, Agrawal R P

机构信息

Sr. Registrar.

Jr. Registrar.

出版信息

J Assoc Physicians India. 2018 Mar;66(3):38-41.

PMID:30341867

Abstract

OBJECTIVE

Diabetes mellitus has been claimed to be a risk factor for the development of pancreatic carcinoma. CA 19-9 has a great sensitivity in detection of pancreatic adenocarcinoma. Metformin exhibits a strong and consistent antiproliferative action on several cancer cell lines including pancreatic cancer. We aim to determine the influence of metformin on CA 19-9 levels in type 2 diabetes mellitus patients.

METHODS

Total 193 patients with type 2 diabetes mellitus were registered for a single centre, cross-sectional study. On the basis of treatment modalities, patients were divided into metformin group (93 patients) and non-metformin group (100 patients). Detailed history, clinical examination, anthropometric measurements, serum CA 19-9 level, glucose and lipid metabolic profiles were determined. Results were presented as mean±SD. Association between CA 19-9 level and other variables were assessed with Pearson correlation and multiple stepwise regression analysis.

RESULTS

Mean CA 19-9 level was 18.99±4.30 U/ml in the metformin group as compared to 30.49±5.61 U/ml in non-metformin group (p<0.001). Mean value of CA 19-9 was found highest among all i.e. 37.05±4.94 U/ml in patients taking insulin. Patients having lifestyle modification for the management of diabetes had their mean CA 19-9 level of 21.39±5.62 U/ml. CA 19-9 level is positively correlated with age, duration of diabetes, BMI, 2-hour Plasma Glucose level, HbA1C, VLDL cholesterol, triglyceride, total cholesterol, LDL cholesterol (p<0.005) and negatively correlated with HDL cholesterol (p<0.001).

CONCLUSION

Metformin is associated with lower level of CA 19-9 in type 2 diabetes mellitus patients. It may have a protective role in preventing pancreatic damage and pancreatic cancer in diabetic individuals. CA 19-9 level could be an effective indicator of glycemic control, disease progression and lipid metabolism in patients with type 2 diabetes mellitus.

摘要

目的

糖尿病被认为是胰腺癌发生的一个危险因素。CA 19-9在检测胰腺腺癌方面具有很高的敏感性。二甲双胍对包括胰腺癌细胞系在内的多种癌细胞系表现出强大且持续的抗增殖作用。我们旨在确定二甲双胍对2型糖尿病患者CA 19-9水平的影响。

方法

总共193例2型糖尿病患者登记参加一项单中心横断面研究。根据治疗方式，患者被分为二甲双胍组（93例患者）和非二甲双胍组（100例患者）。记录详细病史、进行临床检查、人体测量、测定血清CA 19-9水平、血糖和血脂代谢谱。结果以均值±标准差表示。采用Pearson相关性分析和多元逐步回归分析评估CA 19-9水平与其他变量之间的关联。

结果

二甲双胍组的平均CA 19-9水平为18.99±4.30 U/ml，而非二甲双胍组为30.49±5.61 U/ml（p<0.001）。在所有患者中，服用胰岛素的患者CA 19-9的均值最高，即37.05±4.94 U/ml。通过生活方式改变来管理糖尿病的患者，其平均CA 19-9水平为21.39±5.62 U/ml。CA 19-9水平与年龄、糖尿病病程、体重指数、餐后2小时血糖水平、糖化血红蛋白、极低密度脂蛋白胆固醇、甘油三酯、总胆固醇、低密度脂蛋白胆固醇呈正相关（p<0.005），与高密度脂蛋白胆固醇呈负相关（p<0.001）。