Changes of tumor markers after blood glucosecontrol in patients with type 2 diabetes mellitus and influencing factors

  Objective  To observe the dynamic changes of alpha fetoprotein(AFP), cancer embryonic antigen(CEA), cancer antigen 15-3(CA15-3), cancer antigen 19-9(CA19-9) and cancer antigen 72-4(CA72-4) after blood glucose control in type 2 diabetic patients and to analyze the influencing factors.

  Methods  A total of 540 patients with type 2 diabetes were randomly selected as diabetes group, and 300 age-matched healthy people with physical examinations were enrolled into healthy group. The levels of tumor markers between the two groups were compared, and then subgroup analysis was performed based on subjects'age and different HbA1c level. Serum tumor markers of subgroups were compared. The related indicators one month after blood glucose control were rechecked, and multiple Logistic regression analysis was performed for other confounding factors that may affect the level of tumor markers.

  Results  CEA and CA19-9 levels of patients in the diabetes group were significantly higher than those in the healthy group (P < 0.05), and AFP, CA15-3 and CA72-4 levels showed no statistically significant differences between the two groups (P>0.05). Subgroup analysis showed that the higher the blood glucose and the older the age was, the higher the CEA and CA19-9 levels would be, which showed statistically significant between-group differences (P < 0.05). One month after the blood glucose control reaching the standard, the reexamination results of the diabetes group showed that the levels of serum CEA and CA19-9 after control were lower than before the control(P < 0.05). Multiple Logistic regression analysis showed that elder age, longer course of diabetes, smoking and alcohol drinking were all risk factors for the increase of serum CEA and CA19-9 levels, and alcohol drinking was a risk factor for the increase of serum AFP level. Body mass index (BMI), serum creatinine, albumin, triglyceride and low density lipoprotein cholesterol levels showed no correlations with serum tumor markers.

  Conclusion  Before reaching the goal of blood glucose control, the level of serum tumor markers in patients with type 2 diabetes may be increased to a certain extent. Relevant indicators should be fully evaluated clinically, the primary disease should be actively treated, long-term follow-up observation should be performed so as to avoid missed diagnosis.