HbA1c is Positively Associated with Serum Carcinoembryonic Antigen (CEA) in Patients with Diabetes: A Cross-Sectional Study

Abstract

IntroductionTo explore the influence of glycemic levels on the serum carcinoembryonic antigen (CEA) levels in patients with diabetes.MethodsThis is a cross-sectional study. Patients with diabetes aged 18–75 years old were recruited. Those patients with carcinoma, abnormal renal function (serum creatinine ≥ 115 μmol/l), and abnormal hepatic function (serum alanine aminotransferase ≥ 97.5 U/l) were excluded in this study. Blood samples were obtained from every patient after an overnight fasting, and CEA was determined using a chemiluminescent particle immunoassay.ResultsA total of 324 patients with type 1 diabetes and 3019 patients with type 2 diabetes were included in this study. Patients with type 1 diabetes had higher levels of HbA1c (9.5% vs. 8.7%) and CEA (2.79 vs. 2.34 ng/ml), but lower fasting C peptide (0.72 vs. 1.71 ng/ml) than those with type 2 diabetes (all P < 0.001). Data indicated that CEA was higher in patients with smoking, drinking, older age, higher levels of HbA1c, and lower level of fasting C peptide (all P < 0.05). Multiple linear regression analysis indicated that CEA was independently associated with smoking, age, BMI, and HbA1c (all P < 0.05).ConclusionHbA1c was positively associated with the levels of CEA in patients with diabetes. More studies are warranted to investigate whether elevated CEA is associated with increased carcinoma risk in patients with diabetes.

HbA1c showed a positive association with carcinoembryonic antigen (CEA) level in only diabetes, not prediabetic or normal individuals

“…BMI negatively affected CEA levels in only the diabetes group, not in the normal or prediabetes subgroup. Similar to our study, Lu et al reported that male diabetic patients had higher CEA levels than females, and obese diabetic patients had lower CEA levels than patients with a normal BMI . We demonstrated that HbA1c is an independent factor that influences the level of CEA in subjects of both sexes with diabetes.…”

“…We demonstrated that HbA1c is an independent factor that influences the level of CEA in subjects of both sexes with diabetes. Since we reviewed the medical records thoroughly and excluded other clinical conditions that might affect CEA levels, including smoking, the β value was significantly higher than that reported previously by Lu et al…”

“…Litvak et al followed patients who underwent resection for locoregional colorectal cancer and reported that false‐positive or transient elevations of CEA are common in the range of 5 to 15 ng/mL; however, the authors did not reveal the specific cause of this transient elevation. Although false elevation of CEA associated with diabetes has been noted, the relationship between the extent of change in glycemic control status and CEA level had not been demonstrated before this study. Therefore, it is noteworthy that the follow‐up level of CEA significantly decreased as HbA1c decreased with glycemic control, demonstrating the assumed effect of glycemic control on CEA levels, although this conclusion was based on data from a small number of follow‐up subjects.…”

“…These clinical conditions include smoking, 5 hypothyroidism, 6 hypereosinophilia, 7 inflammatory bowel disease, 8 and diabetes. 9 Among those clinical conditions that might affect the level of CEA, diabetes is the most common chronic and metabolic disease. An estimated 285 million people worldwide had diabetes mellitus in 2010, and the number of people with diabetes will rise to 439 million by 2030, representing 7.7% of the total adult population of the world aged 20-79 years.…”

“…Additionally, clinical conditions that might result in false elevation should be considered in the preanalytical phase. These clinical conditions include smoking, hypothyroidism, hypereosinophilia, inflammatory bowel disease, and diabetes . Among those clinical conditions that might affect the level of CEA, diabetes is the most common chronic and metabolic disease.…”