二甲双胍对2型糖尿病患者血清癌胚抗原和糖类抗原19-9的影响

Effect of metformin on serum levels of carcino-embryonic antigen and carbohydrate antigen 19-9 in patients with type 2 diabetic

目的探讨二甲双胍对2型糖尿病患者血清癌胚抗原(CEA)和糖类抗原19-9(CA19-9)的影响,为进一步研究二甲双胍抗癌机制提供临床思路。方法收集治疗血糖达标(Hb A1c<7%)的初诊2型糖尿病136例患者的基本资料,按治疗时有无应用二甲双胍分为双胍组和非双胍组。检测治疗前及3个月后的血清CEA和CA19-9水平变化。结果双胍组和非双胍组糖尿病患者治疗前后的基本资料:双胍组男性略多,体质指数大于非双胍组(P<0.05),餐后血糖非双胍组高于双胍组(P<0.05),年龄、Hb A1c、FBS、低密度脂蛋白胆固醇(LDL-c),甘油三酯(TG)等差异均无明显统计学意义。治疗前后,双胍组和非双胍组的血清CEA和CA19-9水平均各有降低,治疗前后差异有统计学意义(P<0.01)。2组下降幅度比较,双胍组血清CEA下降更明显(P<0.05),而血清CA19-9两组间下降差异无统计学意义(P=0.215)。结论二甲双胍有降低血清CEA和CA19-9水平作用,其中对血清CEA作用部分独立于降糖作用,而对血清CA19-9水平影响和非双胍降糖药物无显著差异。提示二甲双胍的抗肿瘤作用可能部分与降CEA作用有关,为今后进一步研究二甲双胍防癌机制提供循证依据。

Objective To explore the effect of metformin on serum levels of carcino-embryonic antigen（CEA） and carbo- hydrate antigen 19-9 （CA19-9） in patients with type 2 diabetes mellitus（ T-2DM）, and further into its possible anticancer mechanism. Methods We gathered 136 people newly diagnosed with well controlled T-2DM （ HbA1 c 〈 7% ）, and divid- ed them into metformin group and non-metformin groups, we measured serum levels of CEA and CA19-9 in both groups before and after 3 months of treatment. Results The basic data of both groups showed that the mefformin group had slightly more male patients and a higher body mass index （ P 〈 0.05 ）. The non-metformin group had higher postprandial blood glucose （P 〈 0.05 ）. Other factors such as age, HbA1 c, fasting blood glucose （ FBG）, low density lipoprotein-choles- terol C （LDL-C）, triglyceride （TG） were not statistically different. After three months of treatment, the levels of CEA in both groups was significantly lower than those before the treatment separately（ P 〈 0.01 vs. P 〈 0.05 ）, so did the levels of CA19-9 （P 〈 0.05 vs. P 〈 0.05 ）. Between the 2 groups, the decline of CEA in metformin group was more significant than that in the non-metformin group（ P 〈 0.05 ）, but there was no difference in the decline of CA19-9 （ P = 0.215 ）. Conclu- sion Metformin may reduce serum levels of CEA and CA19-9 in patients with T2DM. Its effect on lowering CEA level may be independent of the effect of lowering glucose, but its influence on the level of CA19-9 is not significant as com- pared to other glucose-lowering medications. The anti-cancer activity of metformin may be from its effect on lowering CEA level. This result should provide evidence basis for the possible anticancer mechanism of metformin.