2型糖尿病患者血清CA19-9升高的相关因素分析

Relevant Factors for Elevation of Serum CA19-9 Levels in Patients with Type 2 Diabetes

目的探讨2型糖尿病患者不同血糖状态下血清CA19-9水平及其影响因素。方法收集650例住院2型糖尿病患者及250例体检人群(健康对照组,n=250)数据,根据血糖控制情况,将2型糖尿病患者分为血糖控制良好组(HbA1c<7.0%,良好组,n=217)及血糖控制欠佳组(HbA1c≥7.0%,欠佳组,n=433),比较3组患者的血清CA19-9水平与血糖、血脂、胰岛功能、肝功能及果糖胺等代谢指标之间的相关性。结果欠佳组血清CA19-9水平显著高于健康对照组及良好组(P<0.05);血清CA19-9水平与HbA1c、果糖胺及谷草转氨酶(AST)呈正相关(相关系数分别为0.323、0.317和0.286,P<0.001);回归分析示最终进入回归方程的指标为AST、果糖胺(标准化回归系数为0.437、0.243,P<0.001)。结论果糖胺及AST是影响血清CA19-9水平的独立危险因素,2型糖尿病患者血清CA19-9升高与短期血糖控制欠佳密切相关。

Objective To explore serum CA19-9 concentrations in patients with type 2 diabetes under different levels of glycemic control and the relevant influencing factors. Methods Data of 650 patients with type 2 diabetes and 250 healthy subjects(healthy control group) were collected in this study.These patients were divided into good glycemic control group(HbA1c<7.0%, n =217) and poor glycemic control group(HbA1c≥7.0%, n =433).The relationships of serum CA19-9 levels to blood glucose,blood lipid,pancreatic function,liver function and fructosamine were analyzed. Results Serum CA19-9 levels in poor glycemic control group were higher than those in healthy control group and good glycemic control( P <0.05).The levels of CA19-9 in serum were positively correlated with HbA1c,fructosamine and aspartate aminotransferase( r =0.323,0.317 and 0.286,respectively;P <0.001).Regression analysis showed that aspartate aminotransferase and fructosamine entered the regression equation(standardized coefficient=0.437 and 0.243,respectively;P <0.001). Conclusion Fructosamine and aspartate aminotransferase are the independent risk factors influencing serum CA19-9 levels.The elevation of serum CA19-9 levels is closely related to short-term poor glycemic control in patients with type 2 diabetes.