title: Decreased serum CA19-9 is associated with improvement of insulin resistance and metabolic control in patients with obesity and type 2 diabetes after Roux-en-Y gastric bypass.
abstract: OBJECTIVE
  Patients with type 2 diabetes are known to show elevated serum levels of carbohydrate antigen 19-9 (CA19-9). The aim of the present study was to investigate the possible relationships of CA19-9 with metabolic control, insulin resistance (IR), and pancreatic β-cell function in patients with obesity and type 2 diabetes who underwent Roux-En-Y gastric bypass (RYGB).
  
  
  METHODS
  The present study included 81 healthy volunteers, and 33 patients diagnosed with obesity and type 2 diabetes who underwent RYGB. Anthropometry, serum levels of CA19-9, glucose and lipid metabolic profiles, and serum insulin levels were determined at baseline and at 12 weeks after RYGB.
  
  
  RESULTS
  Changes in CA19-9 were significantly and positively correlated with changes in fasting plasma glucose (r = 0.552, P = 0.001), 2-h post-challenge plasma glucose levels (r = 0.623, P = 0.000), glycated hemoglobin levels (r = 0.819, P = 0.000), glycated albumin levels (r = 0.711, P = 0.000), total cholesterol (r = 0.449, P = 0.009) and the Homeostasis Model of Assessment-IR index (r = 0.407, P = 0.019). Furthermore, a multiple stepwise regression analysis showed that the changes in serum levels of CA19-9 were independently and significantly associated with changes in glycated hemoglobin (β = 0.598, P = 0.000), fasting plasma glucose (β = 0.309, P = 0.000) and Homeostasis Model of Assessment-IR (β = 0.235, P = 0.010) after adjusting for confounding factors.
  
  
  CONCLUSIONS
  CA19-9 could be an effective indicator of IR, and glycemic and lipid metabolism in patients with obesity and type 2 diabetes after rapid metabolic control by RYGB. Additionally, CA19-9 might be a marker with which to evaluate the short-term effects of glycolipid toxicity on IR in these patients.
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease Shanghai, China.
authors.forename: Yinfang
authors.initials: Y
authors.lastname: Tu
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease Shanghai, China.
authors.forename: Haoyong
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai, China.
authors.forename: Pin
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai, China.
authors.forename: Jianzhong
authors.initials: J
authors.lastname: Di
authors.affiliation: Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Han
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease Shanghai, China.
authors.forename: Songhua
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease Shanghai, China.
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Center for Diabetes, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease Shanghai, China.
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
keywords: Carbohydrate antigen 19-9; Insulin resistance; Obesity