血糖波动与2型糖尿病合并结直肠癌患者血清肿瘤标志物及细胞炎症因子水平的关系

Blood glucose fluctuation and serum tumor markers and inflammatory cytokines in patients of type 2 diabetes mellitus concomitant with colorectal cancer

目的:探讨2型糖尿病合并结直肠癌患者血糖波动和相关肿瘤标志物及细胞炎症因子水平的关系。方法:选取85例2型糖尿病合并结直肠癌患者,行72 h动态血糖监测,根据平均血糖波动幅度(MAGE)分为血糖高波动组42例和正常波动组43例,比较两组血清癌胚抗原(CEA)、糖类抗原19-9(CA199)、糖类抗原72-4(CA724)、血清C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,并采用Pearson线性相关分析法分析所有患者MAGE与上述指标的相关性。结果:两组年龄、性别、肿瘤分期、平均空腹血糖(FPG)、平均血糖(MBG)及糖化血红蛋白(HbA1c)差异无统计学意义(P>0.05);高波动组CEA、CA199、CA724、CRP、IL-6水平均高于正常波动组(P<0.05),而两组TNF-α水平差异无统计学意义(P>0.05)。MAGE与血清肿瘤标志物CEA、CA199和CA724水平呈正相关(r=0.614、0.495、0.533,P<0.05),同时与血清炎症细胞因子CRP、IL-6、TNF-α水平亦呈正相关(r=0.652、0.672、0.355,P<0.05)。结论:2型糖尿病合并结直肠癌患者的MAGE与结直肠癌相关肿瘤标志物及细胞炎症因子水平呈正相关,其中血糖高波动的患者CEA、CA199、CA724、CRP、IL-6均高于血糖正常波动的患者,保持血糖水平稳定可能有利于肿瘤标志物及细胞炎症因子水平的控制,降低结直肠癌进展的风险。

Objective:To investigate the relationship between blood glucose fluctuation amplitude and serum tumor markers and inflammatory cytokines in patients with type 2 diabetes mellitus concomitant with colorectal cancer.Methods:Eighty-five patients of type 2 diabetes mellitus concomitant with colorectal cancer were included and undergone dynamic monitoring of glucose level for consecutive 72 hours,and then divided into high blood glucose fluctuation group(n=42)and normal fluctuation level group(n=43)according to the mean amplitude of glycemic excursions(MAGE).The two groups were compared concerning levels of carcinoembryonic antigen(CEA),CA199,CA724,CRP,IL-6 and TNF-α.Pearson linear correlation coefficient was used to analyze the correlation between MAGE and the above indexes in all patients.Results:There were no significant differences in age,gender,tumor stage,fasting blood-glucose(FPG),mean blood glucose(MBG)and HbA1c between the two groups(P>0.05).CEA,CA199,CA724,CRP and IL-6 in the high fluctuation group were higher than those in the normal fluctuation group(P<0.05),yet TNF-αlevel was not significantly different between groups(P>0.05).Pearson linear correlation analysis showed that MAGE was positively correlated with serum levels of CEA,CA199 and CA724(r=0.614;0.495;and 0.533,respectively.all P<0.05)as well as with the levels of CRP,IL-6 and TNF-α(r=0.652;0.672;and 0.355,respectively,all P<0.05).Conclusion:MAGE was positively correlated with the levels of colorectal cancer related tumor markers and inflammatory cytokines in patients with type 2 diabetes mellitus concomitant with colorectal cancer,in which CEA,CA199,CA724,CRP and IL-6 in patients with high blood glucose fluctuation are significantly higher than those with normal blood glucose fluctuation.The findings suggest that maintaining stable blood glucose levels may benefit the control of tumor markers and cellular inflammatory cytokines,and reducing the risk of colorectal cancer progression.