住院糖尿病患者CA199水平与血糖控制程度的关系

目的 探讨糖尿病患者糖化血红蛋白(HbAlc)及糖化血清白蛋白(GA)对血清CA199水平的影响.方法 募集29例正常糖耐量(NGT)个体及371例住院糖尿病患者,其中糖尿病患者按HbAlc水平分为良好(<6.5%)、尚可(6.5%～7.5%)、控制差(>7.5%)3组.比较4组CA199水平;分别计算HbAlc和GA与CA199的相关性;以性别、年龄、病程、体质指数,总胆固醇,甘油三酯,高密度脂蛋白胆固醇,低密度脂蛋白胆固醇,空腹血糖(FBG),HbAlc、GA为自变量,进行逐步多元回归分析,比较各变量对CA199的影响程度.结果 (1)HbAlc控制差组的CA199水平显著高于HbAlc尚可及良好组;(2)HbAlc与CA199相关(r=0.394,P=0.000),GA与CA199相关(r=0.381,P=0.000);(3)回归分析显示HbAlc的标准回归系数为0.364(P=0.000).结论 (1)血糖控制差的糖尿病患者CA199水平明显高于血糖控制尚可及良好的患者;(2)CA199与FBG、餐后2 h血糖、HbAlc及GA水平呈显著正相关;(3)HbAlc是影响CA199的独立危险因素,糖尿病患者CA199升高与血糖长期控制不佳有密切关系.

Relation between the level of serum CA19-9 and glucose control in inpatients with diabetes

Objective To investigate the effect of hemoglobin Alc(HbAlc) and glycated albumin (GA) on serum CA199 in diabetic patients. Methods 29 NGT matched control subjects and 371 hospitalized diabetic patients were enrolled. Diabetic patients were divided into satisfactory group (<6.5%), general group(6.5%-7.5%)and dissatisfactory group(>7.5%) by the level of HbAlc. The levels of serum CA199 among three groups were compared. The relationship between HbAlc and CA199, GA and CA199 was analysed. Multiple stepwise regression analysis was performed to compare the effect of different variables on CA199 as the independent variables were sex,age, duration, TC, TG, HDL, LDL, FBG, PBG, HbAlc and GA. Results (1) CA199 level of the group of HbAlc above 7.5% was significantly higher than the group of HbAlc between 6.5% and 7.5% and the group of HbAlc less than 6.5%. (2) The coefficient of correlation between HbAlc and CA199 was 0.394(P=0.000), and that was 0.381 between GA and CA199 (P=0.000). (3) Multiple stepwise regression analysis show standard regression coefficient of HbAlc is 0.364 (P=0.000). Conclusion (1)CA199 level of diabetic patient in poor glucose control was significantly higher than the patient in good control. ( 2 ) CA199 was positively correlated with FBG, PBG, HbAlc and GA. (3) HbAlc is the independent risk factor of CA199. The elevated CA199 in diabetic patient has close relationship with poor glucose control in a long period.