糖尿病患者血清中CA19-9水平与唾液酸及Lewis血型的关系

目的 探讨2型糖尿病(2DM)患者血清中CA19-9水平升高的原因.方法 对1 000例2DM患者及正常对照进行CA19-9、唾液酸(SA)、HbA1c及Lewis血型检测及相关分析.结果 2DM患者中,CA19-9均值高于对照组,CA19-9阳性率为17.9%.CA19-9阳性2DM患者SA均值低于对照组,CA19-9与SA水平负相关(r=-0.675,P＜0.01).CA19-9阳性Lewisa b-型2DM患者CA19-9水平明显高于Lewisa-b 型患者,并且与SA水平负相关程度提高(r=-0.791,P＜0.01),而CA19-9与HbA1c水平呈正相关(r=0.592,P＜0.01).CA19-9阳性2DM患者治疗后,CA19-9水平下降明显,SA显著升高.结论 2DM患者CA19-9升高是Lewisa血型物质与唾液酸和葡萄糖非酶促反应的结果,非恶性升高.2DM患者治疗后,CA19-9水平下降.

Relationship between levels of serum CA19-9,sialic acid and Lewis blood group in diabetic patients

Objective To investigate the cause of elevated level of serum CA19-9 in the patients with type 2 diabetes mellitus(2DM).Methods CA19-9,sialic acid(SA),HbA1c and Lewis blood group in 1000 patients with type 2 diabetes mellitus and 1000 healthy control subjects were detected and the correlations were analyzed.Results The mean level of CA19-9 in 2DM patients was higher than that in control group(P<0.01) and the positive rate of CA19-9 was 17.9%.In the 2DM patients with positive CA19-9,the mean level of SA was lower than that in control group(P<0.01),and the CA19-9 levels were negatively correlated with SA levels(r=-0.675,P<0.01).The mean level of CA19-9 in the CA19-9-positive 2DM patients with Lewisa b-was transparently higher than that in the patients with Lewisa-b (P<0.01),and the extent of negative correlation between the levels of CA19-9 and SA was more significant(r=-0.791,P<0.01).The CA19-9 levels were positively correlated with HbA1c levels(r=0.592,P<0.01).After treatment CA19-9 levels in the CA19-9-positive 2DM patients decreased,while the SA levels increased obviously.Conclusions The elevation of CA19-9 in 2DM patients may be resulted from the reaction of Lewisa blood substance with SA and glucose by non-enzymatic mode,thus the elevated A19-9 should not be malignant,and the CA19-9 level in 2DM patients decreased following treatment.