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Elevated serum CA19-9 levels in poorly controlled diabetic patients
Insights
Elevated serum CA19-9 levels are common in poorly controlled diabetes, correlating with higher hemoglobin A1 (HbA1) and fasting plasma glucose. These levels may also indicate diabetic complications like retinopathy.
Area of Science:
- Endocrinology
- Clinical Chemistry
Background:
- Serum CA19-9 is typically associated with gastrointestinal cancers.
- Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose levels.
Purpose of the Study:
- To investigate the relationship between serum CA19-9 levels and glycemic control in diabetic patients.
- To explore the correlation of CA19-9 with diabetic complications.
Main Methods:
- Serum CA19-9 levels were measured in 60 diabetic patients and 40 healthy controls.
- Correlations were assessed with hemoglobin A1 (HbA1), fasting plasma glucose, lipids, and diabetes duration.
- CA19-9 levels were compared between patients with and without diabetic complications.
Main Results:
- Serum CA19-9 levels were significantly correlated with HbA1 (r=0.4368) and fasting plasma glucose (r=0.3410).
- Poorly controlled diabetic patients (HbA1 >13% or glucose >200 mg/dl) showed a 50% positive rate for elevated CA19-9, compared to 10% in well-controlled patients.
- Elevated CA19-9 was observed in patients with diabetic retinopathy or proteinuria.
Conclusions:
- Serum CA19-9 levels are increased in diabetic patients, particularly those with poor glycemic control and complications.
- Fasting plasma glucose and HbA1 levels should be considered in patients presenting with elevated CA19-9.
- While not a malignancy, elevated CA19-9 in diabetes may serve as a marker for metabolic derangement and associated complications.
Abstract:
Serum CA19-9 levels were measured in 60 diabetic patients and 40 healthy volunteers. Serum CA19-9 concentration was correlated with hemoglobin A1 (HbA1) (r = 0.4368 P less than 0.005) and fasting plasma glucose levels (r = 0.3410 P less than 0.01). None of the 40 healthy subjects showed elevated CA19-9 concentrations over 37 units/ml as the upper normal value. The percentage of positive serum CA19-9 levels in poorly controlled patients (fasting plasma glucose greater than 200 mg/dl or HbA1 greater than 13%) and moderately to well controlled patients was 50% and 10%, respectively. No correlation was found between the level of CA19-9 and those total cholesterol, and triglycerides, or the duration of diabetes. In patients who had diabetic retinopathy or persistent proteinuria, the CA19-9 concentration was significantly elevated when compared with those without these complications. It has been shown that patients with adenocarcinoma of the gastrointestinal tract have high plasma CA19-9 levels and those who have benign disease have normal CA19-9 levels. Even though diabetes mellitus is not a malignant disease, serum CA19-9 levels were increased in diabetic patients. These results indicate that HbA1 and fasting plasma glucose should be examined in patients with high CA19-9 levels.