Type 2 diabetes mellitus and CA 19-9 levels.
OBJECTIVE
To prospectively investigate serum CA 19-9 levels in type 2 diabetic patients in comparison with age- and gender-matched control subjects.


METHODS
We recorded duration of diabetes and examined fasting glucose levels, HbA1c levels and serum CA 19-9 levels in 76 type 2 diabetic patients and 76 controls. Abdominal CT was performed in order to eliminate abdominal malignancy in the diabetic and control groups.


RESULTS
The average CA 19-9 level was 46.0 +/- 22.4 U/mL for diabetic patients whereas it was 9.97 +/- 7.1 U/mL for the control group (P < 0.001). Regression analysis showed a positive correlation between diabetes and CA 19-9 independent from age, gender, glucose level and HbA1c level (t = 8.8, P < 001). Two of the diabetic patients were excluded from the study because of abdominal malignancy shown by CT at the initial evaluation. For all patients, abdominal CT showed no pancreatic abnormalities.


CONCLUSIONS
CA 19-9 is a tumor-associated antigen, which is elevated in pancreatic, upper gastrointestinal tract, ovarian hepatocellular, and colorectal cancers, as well as in inflammatory conditions of the hepatobiliary system, biliary obstruction and in thyroid diseases. Diabetes has been claimed to be a risk factor for pancreatic cancer, which is increasing its incidence and has one of the lowest survival rates of all cancers. CA 19-9 is used in the diagnosis of pancreatic cancer but is also a marker of pancreatic tissue damage that might be caused by diabetes. We propose that a higher cut-off value of CA 19-9 should be used in diabetics to differentiate benign and malignant pancreatic disease, and subtle elevations of CA 19-9 in diabetics should be considered as the indication of exocrine pancreatic dysfunction.
Uygur-Bayramicli
Oya
O
Department of Gastroenterology, Kartal State Hospital, Istanbul 81110, Turkey.
Dabak
Resat
R
Orbay
Ekrem
E
Dolapcioglu
Can
C
Sargin
Mehmet
M
Kilicoglu
Gamze
G
Guleryuzlu
Yuksel
Y
Mayadagli
Alpaslan
A
D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D018395:CA-19-9 Antigen / Q000097:blood*; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000276:immunology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000378:metabolism; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D001786:Blood Glucose; D018395:CA-19-9 Antigen; D006442:Glycated Hemoglobin