title: Study on the mechanism causing elevation of serum CA19-9 levels in diabetic patients.
abstract: Serum CA19-9 levels are often elevated in diabetic patients. To elucidate this mechanism, we investigated the metabolism of CA19-9 in diabetic patients without obvious cancer. Study 1 included 119 patients in whom HbA1c, glycated albumin (GA) and CA19-9 were measured at the time of hospital admission. Study 2 examined 6 patients with markedly elevated CA19-9 levels (≥100 U/mL). Their half-lives for HbA1c, GA, and serum CA19-9 were calculated using the data before and after diabetes treatment. Three diabetic patients with pancreatic cancer were also examined as controls. In Study 1, serum CA19-9 (logarithmically transformed value) was significantly correlated with fasting plasma glucose (FPG), HbA1c and GA. On multivariate analysis, GA and FPG, but not HbA1c, were significant explanatory variables for serum CA19-9. In Study 2, serum CA19-9 decreased together with HbA1c and GA after diabetes treatment. The calculated half-lives for HbA1c, GA, and serum CA19-9 were 33.8 days, 16.1 days, and 10.9 days, respectively. The half-life of serum CA19-9 was longer in the study patients than that reported in patients with malignant tumors. By contrast, in the diabetic patients with pancreatic cancer serum CA19-9 showed a marginal decrease after diabetes treatment. Taken all together, prolonged half-life of serum CA19-9 may contribute to the increase in serum CA19-9 levels in diabetic patients without obvious cancer.
authors.affiliation: Department of Internal Medicine, Kinki Central Hospital, Itami 664-8533, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Murai
authors.forename: Sumiko
authors.initials: S
authors.lastname: Soga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
authors.forename: Michio
authors.initials: M
authors.lastname: Otsuki
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kitada
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Saisho
authors.forename: Hideji
authors.initials: H
authors.lastname: Nakamura
authors.forename: Soji
authors.initials: S
authors.lastname: Kasayama
authors.forename: Masafumi
authors.initials: M
authors.lastname: Koga
mesh_terms: D000328:Adult; D000368:Aged; D018395:CA-19-9 Antigen / Q000097:blood*; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D017127:Glycation End Products, Advanced; D006207:Half-Life; D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D007328:Insulin / Q000494:pharmacology / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000032:analysis; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology; D015854:Up-Regulation; D000093423:Glycated Serum Albumin
chemical_list: D018395:CA-19-9 Antigen; D006442:Glycated Hemoglobin; D017127:Glycation End Products, Advanced; D007004:Hypoglycemic Agents; D007328:Insulin; D012709:Serum Albumin; D000093423:Glycated Serum Albumin; C517652:hemoglobin A1c protein, human