Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Sci Rep. 2024 Sep 28;14(1):22506. doi: 10.1038/s41598-024-73404-w.
Carbohydrate antigen 19-9 (CA19-9) levels are associated with glycemic control, insulin resistance, and chronic complications in patients with type 2 diabetes (T2D). Women generally show higher CA19-9 levels despite a greater T2D prevalence in men. We evaluated the sex-specific longitudinal associations between CA19-9 levels and T2D incidence. Korean adults (n = 329,380) without previous cancer or T2D were categorized into four groups based on their CA19-9 levels. The study end point was the development of incident T2D during follow-up. Cox proportional hazards models were used to estimate hazard ratios (HR) according to CA19-9 levels. During a median follow-up of 6.1 years (3.3-9.3 years), the incidence rates of T2D were 9.9 per 1,000 person-years in men and 3.6 per 1,000 person-years in women. In the time-dependent analysis, adjusted HRs (95% confidence intervals) for incident T2D comparing CA19-9 levels of 10.0-19.9, 20.0-29.9, and ≥ 30 U/mL to the reference (< 10 U/mL) were 1.08 (1.04-1.13), 1.18 (1.07-1.30), and 1.64 (1.35-1.99), respectively, among men. However, this association was not observed in women. The association between CA19-9 category and incident T2D significantly differed by sex (P = 0.006). Among young and middle-aged Korean adults, elevated CA19-9 levels were significantly associated with increased risk of type 2 diabetes in men but not in women. Elevated CA19-9 levels in men could be a useful marker for identifying individuals at high risk of developing T2D. Evaluation approaches for individuals with elevated CA19-9 levels should be sex-specific.
糖类抗原 19-9（CA19-9）水平与 2 型糖尿病（T2D）患者的血糖控制、胰岛素抵抗和慢性并发症有关。尽管男性 T2D 的患病率较高，但女性的 CA19-9 水平通常更高。我们评估了 CA19-9 水平与 T2D 发病率之间的性别特异性纵向关联。在没有先前癌症或 T2D 的韩国成年人（n=329380）中，根据 CA19-9 水平将其分为四组。研究终点是随访期间 T2D 的发生。使用 Cox 比例风险模型根据 CA19-9 水平估计风险比（HR）。在中位随访 6.1 年（3.3-9.3 年）期间，男性 T2D 的发病率为每 1000 人年 9.9 例，女性为每 1000 人年 3.6 例。在时间依赖性分析中，与 CA19-9 水平<10.0 U/mL 相比，CA19-9 水平为 10.0-19.9、20.0-29.9 和≥30 U/mL 的男性发生 T2D 的调整后 HR（95%置信区间）分别为 1.08（1.04-1.13）、1.18（1.07-1.30）和 1.64（1.35-1.99）。然而，这种关联在女性中并未观察到。CA19-9 类别与 T2D 事件之间的关联在性别上差异有统计学意义（P=0.006）。在年轻和中年韩国成年人中，CA19-9 水平升高与男性 T2D 风险增加显著相关，但在女性中则不相关。男性 CA19-9 水平升高可能是识别 T2D 高危个体的有用标志物。CA19-9 水平升高个体的评估方法应具有性别特异性。
