二甲双胍对2型糖尿病患者CA125水平的影响及其相关因素  

Effects of mefformin therapy on serum CA125 levels and its related factors in type 2 diabetics

作　　者：侯沃霖[1] 张丹丹[1] 陆蔚[1] 殷峻[1] 李鸣[1] 卢逢娣[1] 刘芳[1] 贾伟平[1] 

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科上海市糖尿病临床医学中心上海市重中之重代谢病临床医学中心上海市糖尿病研究所上海市糖尿病重点实验室,200233

出　　处：《中华医学杂志》2014年第18期1380-1383,共4页National Medical Journal of China

基　　金：国家自然科学基金（81070650）

摘　　要：目的探索二甲双胍对肝肾功能正常的2型糖尿病患者血清糖类抗原125（CA125）水平的影响及其相关因素。方法人选2011年3月—2012年3月上海市第六人民医院内分泌代谢科住院的1136例2型糖尿病患者，按性别、年龄、体质指数分组，根据是否服用二甲双胍进一步分为双胍组和非双胍组，比较各组问血清CA125水平及其他生化特征，分析影响血清CA125水平的因素。结果总体人群中双胍组血清CA125水平明显低于非双胍组[10．51（8．18，13．80）比11．93（9．05，15．52），P〈0．01]。30—39岁和50～59岁的男性患者及1〉50岁的女性患者用药后CA125水平明显下降（P〈0．05）。与非双胍组相比，双胍治疗后体重正常的患者和肥胖的女性患者CA125水平下降更为明显，差异有统计学意义（P〈0．05）。相关分析表明CA125与性别、糖化血红蛋白（HbA1c）、糖化血清白蛋白（GA）等呈正相关（P〈0．05），而与应用二甲双胍、血清肌酐（SCr）呈负相关（P〈0．01）。多元逐步回归分析的结果揭示GA、二甲双胍、性别、TG是血清CA125的独立影响因素（均P〈0．05）。结论2型糖尿病患者应用二甲双胍治疗与血清CA125水平降低有关，尤其是女性患者。Objective To explore the effects of metformin therapy on serum carbohydrate antigen 125 （CA125） levels and its related factors in type 2 diabetics with normal liver and kidney function. Methods Serum CA125 level was measured and compared for a total of 1 136 type 2 diabetics. They were assigned into groups according to gender, age and body mass index （BMI） and subgroups according to metformin dosing. Associations between CA125 and other variables were assessed with Spearman or Pearson＇s correlation and multiple stepwise regression analysis. Results The CA125 level of metformin group was significantly lower than that of non-metformin group （10. 51 （8. 18, 13.80） vs 11.93（9. 05, 15.52） U/ml, P 〈 0. 01 ）. The CA125 levels of males aged 30 - 39 and 50 - 59 as well as females aged over 50 remarkably decreased after metformin dosing （all P 〈 0. 05 ）. The difference of CA125 level between metformin and non- metformin groups in patients with normal BMI and obese females reached statistical significance （ all P 〈 0. 05）. The correlation analysis showed that serum CA125 level was positively associated with gender, HbA1 c, glycated serum albumin, triglyeeride, total cholesterol （P 〈 0. 05 ）, but negatively with metformin and creatiniue （ P 〈 0. 01 ） . Multiple stepwise regression analysis further revealed that GA, metformin dosing, gender and total glyeerides were independent influencing factors of CA125 concentrations （all P 〈 0. 05 ）. Conclusion Metformin dosing is an independent associated factor of serum CA125 levels reduction in type 2 diabetics, especially females.

关 键 词：糖尿病 2型 二甲双胍 CA125 性别差异 

分 类 号：R587.1[医药卫生—内分泌]