2型糖尿病患者血清胃肠道肿瘤相关抗原CA199的变化及其临床意义

摘要

Objective To investigate the relationship between CA199 and clinical indicators and its related factors in patients with type 2 diabetes mellitus(T2DM). Methods A total of 1224 hospitalized T2DM patients were enrolled retrospectively from the Endocrinology and metabolism department of our hospital. All the patients were divided into two groups according to CA199 level:negative group (CA199<37 U/ml) and positive group(CA199≥37 U/ml). Clinical and biochemical data were compared between the two groups. Results The level of FPG,HbA1c,UACR,and the prevalence of diabetic microvascular complications were significantly higher in CA199 positive group than in negative group[(13.12±4.58)vs(10.22±4.01)mmol/L,(10.84±2.58)% vs (8.78±2.22)%,(38.25±3.15) vs (29.09±1.02)mg/g,P<0.05]. Serum albumin level was lower in CA199 positive group than in negative group[(38.59±5.33) vs (40.13±5.63)g/L,P<0.05]. Pearson correlation analysis showed that CA199 was associated with FPG,HbA1c,and serum albumin(r=0.251,0.260,-0.082,P<0.05 or P<0.01). Multiple logistic regression analysis further found that FPG and HbA1c were the independent risk factors for CA199(β=0.793,0.975,P<0.05). Conclusion The elevated CA199 in T2DM patients correlated with poor glucose control and development of diabetic microvascular complications.%目的 探讨T2DM患者胃肠道肿瘤相关抗原CA199的变化及与临床指标的相关性和影响因素. 方法 回顾性收集2007~2014年于我院内分泌科住院的1224例T2DM患者的临床资料,按CA199水平分为阴性组(<37 U/ml)和阳性组(≥37 U/ml).比较两组一般临床资料. 结果CA199阳性组FPG、HbA1c、尿微量白蛋白与肌酐比值(UACR)水平高于阴性组[(13.12±4.58) vs (10.22±4.01) mmol/L,(10.84±2.58)% vs (8.78±2.22)%,(38.25±3.15) vs (29.09±1.02) mg/g,P<0.05],微血管并发症发生率增加;而阳性组的血清白蛋白水平低于阴性组[(38.59±5.33)vs(40.13±5.63)g/L,P<0.05].Pearson相关性分析显示,CA199与FPG、HbA1c、血清白蛋白有相关性(r=0.251、0.260、-0.082,P<0.05或P<0.01).多元线性回归分析显示,FPG、HbA1c是CA199升高的独立危险因素(β=0.793、0.975,P<0.05或P<0.01). 结论 T2DM患者CA199升高与血糖控制不佳及其微血管并发症关系密切.