Effect of varying levels of Glycemia on CA-19.9
DOI:
https://doi.org/10.51253/pafmj.v74i2.9374Keywords:
CA-19.9, Fasting plasma glucose, HbA1c, Type-2 Diabetes MellitusAbstract
Objective: To compare differences in CA-19.9 levels among participants with and without Type 2 diabetes mellitus and to correlate increasing glycemia levels and HbA1c with CA-19.9
Study Design: Comparative cross-sectional study
Place and Duration of Study: Department of Chemical Pathology, Combined Military Hospital, Multan Pakistan, from Feb to Aug 2022.
Methodology: One hundred thirty-one patients with diabetes and without diabetes were enrolled. CA-19.9, fasting plasma glucose, HbA1c, amylase, lipase, and anthropometric parameters were assessed. Patients with diabetes were divided into three groups based on FPG and HbA1c levels to investigate the relationship between CA-19.9 and glycemic status.
Results: There was no significant difference among CA-19.9 of Controls and patients with diabetes (19.45±14.89 versus 15.83±13.98, p=0.155). FPG and HbA1c showed a moderate positive correlation to CA-19.9 (r = 0.283, p= 0.001 and r= = 0.305, p<0.001 respectively). Inter-group comparison (post-hoc analysis) showed a significant rise of CA-19.9 with increasing HbA1c in groups with HbA1c 5.61-7.0% Vs >7.0% (p=0.020), HbA1c <5.6 %Vs >7.0%(p=0.037) and with increasing FPG in groups with FPG 5.6-7.0 mmol/L Vs >7.0 mmol/L (p=0.005).
Conclusion: The glycemic status of patients with diabetes can influence their serum CA-19.9 levels, and glycemic control should be considered while interpreting these levels in such patients. T2DM patients with poor glycemic control have a higher CA of 19.9 than those with better control.
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Murray MD, Burton FR, Di Bisceglie AM. Markedly elevated
serum CA 19-9 levels in association with a benign biliary
stricture due to primary sclerosing cholangitis. J Clin
Gastroenterol 2007; 41(1): 115-117.
https://doi.org/10.1097/mcg.0b013e31802dd094
Locker GY, Hamilton S, Harris J, Jessup JM, Kemeny N,
Macdonald JS, et al. ASCO 2006 update of recommendations for
the use of tumor markers in gastrointestinal cancer. J Clin Oncol
; 24: 5313–5327.
https://doi.org/10.1200/jco.2006.08.2644
Saif MMS, M. Al-Asbahy W, Ali Al-Fakih A, Albadani AM.
Serum CA19–9 Levels and Pancreatic Beta Cell Destruction in
Type 2 Diabetes Mellitus Patients. J Pharm Res Int 2017; 14(6): 1-
https://doi.org/10.9734/BJPR/2016/30808
Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al
Kaabi J. et al. Epidemiology of Type 2 Diabetes - Global Burden
of Disease and Forecasted Trends. J Epidemiol Glob Health 2020;
(1): 107-111. https://doi.org/10.2991/jegh.k.191028.001
Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of
type 2 diabetes mellitus and its complications. Nat Rev
Endocrinol 2018; 14(2): 88-98.
https://doi.org/10.1038/nrendo.2017.151
Lin X, Xu Y, Pan X, Xu J, Ding Y, Sun X, et al. Global, regional,
and national burden and trend of diabetes in 195 countries and
territories: an analysis from 1990 to 2025. Sci Rep 2020; 10(1):
https://doi.org/10.1038/s41598-020-71908-9
Meo SA, Zia I, Bukhari IA, Arain SA. Type 2 diabetes mellitus in
Pakistan: Current prevalence and future forecast. J Pak Med
Assoc 2016; 66(12): 1637-1642.
Rosewicz S, Wiedenmann B. Pancreatic carcinoma. Lancet 1997;
(9050): 485-489.
https://doi.org/10.1016/s0140-6736(96)05523-7
Singla R, Goyal A, Mahajan B. Effect of glycemic status on
serum CEA and CA 19-9 levels in patients of diabetes mellitus in
northern India. Int J Health Sci Res 2018; 8(2): 67-72
Everhart J, Wright D. Diabetes mellitus as a risk factor for
pancreatic cancer. A meta-analysis. JAMA 1995; 273(20): 1605-
Aamir AH, Ul-Haq Z, Mahar SA, Qureshi FM, Ahmad I, Jawa A,
et al. Diabetes Prevalence Survey of Pakistan (DPS-PAK):
prevalence of type 2 diabetes mellitus and prediabetes using
HbA1c: a population-based survey from Pakistan. BMJ Open
; 9(2): e025300.
https://doi.org/10.1136/bmjopen-2018-025300
Uygur-Bayramicli O, Dabak R, Orbay E, Dolapcioglu C, Sargin
M, Kilicoglu G, et al. Type 2 diabetes mellitus and CA 19-9
levels. World J Gastroenterol 2007; 13(40): 5357-5359.
https://doi.org/10.3748/wjg.v13.i40.5357
DeFronzo RA, Ferrannini E, Groop L, Henry RR, Herman WH,
Holst JJ, et al. Type 2 diabetes mellitus. Nat Rev Dis Primers
; 1: 15019. https://doi.org/10.1038/nrdp.2015.19
Gullo L. Diabetes and the risk of pancreatic cancer. Ann Oncol
; 10 Suppl 4: 79-81.
Khan SH, Shahid R, Fazal N, Ijaz A. Comparison of Various
Abdominal Obesity Measures for Predicting Metabolic
Syndrome, Diabetes, Nephropathy, and Dyslipidemia. J Coll
Physicians Surg Pak 2019; 29(12): 1159-1164.
https://doi.org/10.29271/jcpsp.2019.12.1159
Tsena A, Barbara M, Rosenkranz L. Dilemma of elevated CA 19-
in biliary pathology.Pancreatology 2018; 18(8): 862-867.
https://doi.org/10.1016/j.pan.2018.09.004
Benhamou PY, Vuillez JP, Halimi S, Meffre G, Bachelot I.
Influence of metabolic disturbances of diabetes mellitus on
serum CA 19-9 tumor marker. Diabete Metab 1991; 17(1): 39-43.
Gul K, Nas S, Ozdemir D, Gumus M, Ersoy R, Cakir B. CA 19-9
level in patients with type 2 diabetes mellitus and its relation to
the metabolic control and microvascular complications. Am J
Med Sci 2011; 341(1): 28-32.
https://doi.org/10.1097/MAJ.0b013e3181f0e2a0
Yu H, Li R, Zhang L, Chen H, Bao Y, Jia W. Serum CA19-9 level
associated with metabolic control and pancreatic beta cell
function in diabetic patients. Exp Diabetes Res 2012; 2012:
https://doi.org/10.1155/2012/745189
Kim S, Park BK, Seo JH. Carbohydrate antigen 19-9 elevation
without evidence of malignant or pancreatobiliary diseases. Sci
Rep 2010; 10: 8820. https://doi.org/10.1038/s41598-020-65720-8
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