The serum levels of tumor marker CA19-9, CEA, CA72-4, and NSE in type 2 diabetes without malignancy and the relations to the metabolic control

Shang, Xiaojing; Song, Chun‐Qing; Du, Xiaoping; Shao, Hailin; Xu, Danyan; Wang, Xiaolai

doi:10.15537/smj.2017.2.15649

Cited by 30 publications

(33 citation statements)

References 12 publications

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“…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.…”

Section: Discussionmentioning

confidence: 57%

“…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; 36 however, the authors did not reveal the specific cause of this transient elevation. Although false elevation of CEA associated with diabetes has been noted, 9,13,14 There are some limitations of this study. First, we could not perform an experiment to elucidate the clear mechanism connecting diabetes or increased HbA1c to CEA levels.…”

Section: Discussionmentioning

confidence: 87%

“…12 Several studies have investigated the relationship between CEA levels and diabetes. 9,13,14 However, no studies have performed comprehensive medical checkups and screening, including endoscopic examinations, imaging studies, and wide-ranging blood tests including tumor markers and glycated hemoglobin, to rule out malignancy or other benign conditions that might affect CEA levels, as done in our health screening center, the Seoul National University Hospital (SNUH) Healthcare System Gangnam Center. 15 Furthermore, no study has showed the differences in CEA levels among normal, prediabetic, and diabetic individuals, or reported serial data on CEA levels associated with the glycemic control status in diabetic patients.…”

Section: Additionally Clinical Conditions That Might Results In Falsementioning

confidence: 99%

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

Chung

Lee

Roh

2019

Clinical Laboratory Analysis

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Background This study was conducted to investigate the association of carcinoembryonic antigen (CEA) and glycated hemoglobin (HbA1c) in normal, prediabetic, and diabetic subjects. Methods A total of 2,911 participants who underwent general health checkups were enrolled and categorized into the normal, prediabetes, and diabetes groups. Demographic, anthropological, and clinical variables were investigated, and correlations with CEA were analyzed. For 28 diabetic subjects with CEA levels above the upper limit, the follow‐up CEA and HbA1c data were analyzed. Results Carcinoembryonic antigen levels were significantly different among the normal, prediabetes, and diabetes groups (1.7 ± 1.1 vs 2.0 ± 1.1 vs 2.5 ± 1.5; P < 0.001), and men had higher CEA levels than women in all three groups. Correlation analysis identified a significant positive correlation between serum CEA and HbA1c in the diabetes group using unadjusted and adjusted models (r = 0.189, P < 0.001 and r = 0.218, P < 0.001), and multiple linear regression analysis also revealed that HbA1c was independently and positively correlated with CEA in the diabetes group (β = 0.275, P < 0.001). However, these relationships were inconsistent in the normal and prediabetes groups. The changes in CEA and HbA1c from baseline to follow‐up (delta CEA and delta HbA1c) showed a significant positive correlation (P = 0.021). Conclusions In diabetes, the CEA level was independently and positively correlated with glycemic control status. Additionally, the change in CEA level (delta CEA) showed a positive correlation with the change in HbA1c level (delta HbA1c) in the follow‐up data analysis.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 87%

Section: Additionally Clinical Conditions That Might Results In Falsementioning

confidence: 99%

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

Chung

Lee

Roh

2019

Clinical Laboratory Analysis

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“…The level of CA 19-9 has been explored in various studies; it was increased in patients with type 2 diabetes and highly correlated with glycemic control [ 18 – 20 ]. CEA has also been reported to be associated with hyperglycemia in patients with diabetes in small-scale studies [ 19 , 20 ]. However, the influence of glycemic control on the levels of CEA was scarcely investigated in large-scale samples.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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“…A higher level of CA19‐9 has often been used as a clinical tumor marker of pancreatic cancer. Elevated serum CA19‐9 levels were observed not only in malignant tumors, but also in patients with inflammatory conditions, including pancreatitis and diabetes mellitus. A positive association between high serum CA19‐9 levels with the degree of impaired glucose regulation has also been reported.…”

Section: Introductionmentioning

confidence: 99%

Association between cancer antigen 19‐9 and diabetes risk: A prospective and Mendelian randomization study

Wang²,

Wang³

et al. 2019

J of Diabetes Invest

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Aims/Introduction: Elevated serum cancer antigen 19-9 (CA19-9) levels have been found in diabetes patients in most observational studies; however, whether there is a causal association between CA19-9 and diabetes mellitus is unclear. Materials and Methods: Our study was carried out based on the Dongfeng-Tongji cohort comprising 27,009 individuals. We first investigated the associations between serum CA19-9 levels and incident diabetes mellitus risk in a prospective cohort study (12,700 individuals). Then, we explored the potential causal relationship between CA19-9 and diabetes mellitus risk in a cross-sectional study (3,349 diabetes mellitus patients and 8,341 controls) using Mendelian randomization analysis. A weighted genetic risk score was calculated by adding the CA19-9 increasing alleles in five single-nucleotide polymorphisms (rs17271883, rs3760776 and rs3760775 in FUT6, rs11880333 in CA11, rs265548 in B3GNT3, and rs1047781 in FUT2), which were identified in a previous genome-wide association study on serum CA19-9 levels.Results: In the prospective study, a total of 1,004 incident diabetes mellitus patients were diagnosed during a mean 4.54-year follow-up period. Elevated serum CA19-9 level was associated with a higher incident diabetes risk after adjustment for confounders, with a hazard ratio of 1.20 (95% confidence interval 1.11-1.30) per standard deviation (12.17 U/ mL) CA19-9 increase. Using the genetic score to estimate the unconfounded effect, we did not find a causal association of CA19-9 with diabetes risk (odds ratio per weighted CA19-9-increasing allele: 0.99, 95% confidence interval 0.94-1.04; P = 0.61). Conclusions: The present study did not support a causal association of serum CA19-9 with diabetes risk. CA19-9 might be a potential biomarker of incident diabetes mellitus risk.has not been clear 5,6 . Even though studies showed that longterm diabetes mellitus is a risk factor for pancreatic cancer, an increasing amount of evidence reminds us that pancreatic cancer might be a diabetogenic factor 5,7,8 .Cancer antigen 19-9 (CA19-9), a member of the Lewis antigen family, is expressed in some tissues, such as pancreatic and biliary ductal cells, in very small amounts in the normal human body. A higher level of CA19-9 has often been used as a clinical tumor marker of pancreatic cancer 9 . Elevated serum CA19-9 levels were observed not only in malignant tumors, but also

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The serum levels of tumor marker CA19-9, CEA, CA72-4, and NSE in type 2 diabetes without malignancy and the relations to the metabolic control

Cited by 30 publications

References 12 publications

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

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

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

Association between cancer antigen 19‐9 and diabetes risk: A prospective and Mendelian randomization study

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