2型糖尿病患者CA242水平与唾液酸及Lewis血型物质的关系

The relationship between serum levels of CA242, sialic acid and Lewis blood-group substance in type 2 diabetes mellitus patients

目的探讨2型糖尿病（T2DM）患者血清中CA242水平与唾液酸及Lewis血型物质的关系。方法用凝集法、ABC-ELISA法、酶法和免疫比浊法分别检测2000例T2DM患者及500名健康对照者的Lewis血型以及血清中CA242、唾液酸（SA）、糖化血红蛋白（HbAle）水平，并分析它们之间的关系。结果T2DM患者CA242水平和阳性率分别为（20470±14860）U／L、6.0％（121／2000），明显高于健康对照者的（10950±8490）U／L、0.4％（2／500），差异有统计学意义（t′=18.87，X^2=26.1，P均〈0.01）。T2DM患者SA水平为（51.5±18.6）μg/L，明显低于健康对照者的（56.3±13.8）μg／L，差异有统计学意义（t′=6.45，P〈0.01）。CA242阳性T2DM患者的CA242水平与SA呈负相关（r=-0.693，P〈0.01），与HbAle呈正相关（r=0.547，P〈0.01）。98.3％（119／121）CA242阳性T2DM患者的Lewis血型属于I型链结构。CA242阳性的T2DM患者治疗后，CA242水平显著下降，SA水平明显升高，治疗前后的CA242和SA水平分别为30570（27040—42630）、（22350±13400）U／L和（44.5±13.5）、（55.5±17.2）μg/L，差异有统计学意义（U=5.32，t′=5.53，P均〈0.01）。结论T2DM患者血清中CA242升高可能是Lewis血型的I型物质与唾液酸非酶促反应的结果，而非恶性升高。通过控制T2DM患者血糖，CA242水平能得到有效控制。

Objective To investigate the relationship between levels CA242 , sialic acid and Lewis blood-group substance in type 2 diabetes mellitus（T2DM） patients. Methods Lewis blood group, serum CA242, sialic acid （SA） and HbAlc levels were separately detected by agglutination test, ABC-ELISA assay, enzymatic method and immunoturbidimetric assay and the correlations between them were analyzed in 2000 T2DM patients and 500 healthy controls. Results The mean level and positive ratio of serum CA242 in T2DM patients were （20470±14860）U/L and 6.0% （121/2000）, which were obviously higher than those of controls [（10950±8490） U/L, 0.4% （2/500）]. There were significantly statistical differences （t′= 18.87,P 〈 0.01 ,X^2=26.1, P 〈 0.01）. The SA level of T2DM patients was （51.5±18.6）μg/L, which was obviously lower than that of controls[ （56.3±13.8）μg/L] （t′=6. 45, P 〈0.01）. The CA242 levels were negatively correlated with SA （ r = - 0.693, P 〈 0.01） but positively correlated with HbA1 c （ r = 0. 547, P 〈0. 01 ） in CA242-positive T2DM patients. The Lewis blood group in 98.3% （ 119/121 ） CA242 positive T2DM patients belong to type-I chain substrate. After treatment, the CA242 levels were decreased in CA242-positive T2DM patients whereas SA levels were increased obviously. The CA242 and SA levels of pre-and post-therapy were 30 570 （27040-42630）, （22350±13400） U/L and （44.5± 13.5）, （55.5±17.2）μg/L, respectively. There were significantly statistical differences （ U = 5.32, P 〈 0. 01, t′= 5.53, P 〈 0.01）. Conclusions The elevation of serum CA242 levels in T2DM patients is probably due to reaction between type-1 chain substrate and SA by non-enzymatic mode. It is not the consequence ofmalignancy. In T2DM patients, CA242 level can be effectively controlled by regulating blood sugar levels.