中国全科医学2017，Vol.20Issue(32)：3983-3990,8.DOI:10.3969/j.issn.1007-9572.2017.11.002
2型糖尿病患者肿瘤标志物水平及其影响因素研究
Levels of Tumor Markers and Associated Factors in Type 2 Diabetes Mellitus
摘要
Abstract
Objective To investigate the levels of serum tumor markers and associated factors in type 2 diabetes mellitus (T2DM).Methods Two hundred and eight patients with T2DM who received inpatient treatment in Department of Endocrinology,Nanjing Pukou Hospital of TCM,and Department of Endocrinology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,were selected as the participants of study.The serum albumin,glycosylated hemoglobin (HbA1c),triglyceride (TG),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C) and serum tumor markers,such as CA125,CA199,alpha fetoprotein (AFP),carcino-embryonic antigen (CEA),CA72-4,CA153,CA242,CA50,CYFRA21-1,neuron-specific enolase (NSE) and serum ferritin (SF) levels were detected.In the steamed bun meal tolerance test,the levels of fasting plasma glucose (FPG),2 h postprandial plasma glucose (2 hPG),fasting insulin (FINS),2 h postprandial insulin (2 hINS),fasting C-peptide (FC-P),2 h postprandial C-peptide (2 hC-P) were detected.Results Among the 208 patients,there were 6 cases of abnormal CA125 (2.9％),30 cases of abnormal CA199 (14.7％),2 cases of abnormal AFP (1.0％),5 cases of abnormal CEA (2.5％),23 cases of abnormal CA72-4 (11.6％),5 cases of abnormal CA153 (2.5％),17 cases of abnormal CA242 (8.5％),6 cases of abnormal CA50 (3.0％),15 cases of abnormal CYFRA21-1 (7.5％),12 cases of abnormal NSE (6.0％) and 11 cases of abnormal SF (5.4％).The levels of CEA,CA153 and CYFRA21-1 were higher in patients aged ＞60 years old than in those aged ≤60 years old (P ＜0.05);patients with the course of T2DM ＞ 10 years had higher levels of CEA and CA153 but lower SF levels than those with the course of T2DM ≤ 10 years (P ＜0.05);the levels of CA199,CEA,CA242,CA50 and SF were higher in patients with HbA1c ＞ 7.0％ than in those with HbA1c ≤7.0％ (P ＜ 0.05);there were statistically significant differences in the levels of CA199,CA72-4,CA242,CA50 and SF among T2DM patients with FPG ＜ 7.0,7.0-10.0 and ＞ 10.0 mmol/L (P ＜ 0.05);the level of CA199 in patients with HOMA-IR ＞ 8.90 was higher than that in those with HOMA-IR ≤ 8.90 (P ＜ 0.05);there were statistically significant differences in the levels of CA199 and SF among patients with HOMA-HBCI ＜ 20.25,20.25-35.93,35.94-83.03 and ＞83.03 (P ＜0.05).Multivariate linear regressions analysis showed that the medication history of INS [β =-16.275,95％ CI (-33.729,-1.179)],HbA1c [β=3.495,95％CI (1.663,8.653)],HDL-C [β=-48.374,95％CI (-85.373,-11.374)],HOMA-IR [β=1.107,95％CI (0.309,1.906)] and HOMA-HBCI [β=-0.419,95％CI (-0.955,-0.194)] were associated factors of CA199 levels in T2DM patients (P ＜ 0.05).Conclusion The abnormally increased levels of a variety of tumor markers,found in T2DM patients,are related to the FPG levels under control,insulin resistance and islet cell function.Insulin resistance and poor blood glucose control are the risk factors of the increased CA199 level,while high HDL-C and islet cell function are its protective factors.关键词
糖尿病,2型/肿瘤标记,生物学/胰岛素抗药性/脂蛋白类,HDL/血红蛋白A,糖基化Key words
Diabetes mellitus, type 2/Tumor markers, biological/Insulin resistance/Lipoproteins, HDL/Hemoglobin A, glycosylated分类
医药卫生引用本文复制引用
蒋斌,沈山梅,金露,田甜,孙梦,毕艳,朱大龙..2型糖尿病患者肿瘤标志物水平及其影响因素研究[J].中国全科医学,2017,20(32):3983-3990,8.基金项目
江苏省医学重点学科(代谢病学)资助项目(XK201105) （代谢病学）
江苏省中医药局科技项目(YB2015072) （YB2015072）
南京市卫生青年人才第一层次人才培养工程(南京市医学科技发展资金资助) （南京市医学科技发展资金资助）
南京市内分泌代谢病临床医学中心资助项目 （）
南京市浦口区社会发展与科技项目(S2014-10) （S2014-10）
