2型糖尿病患者铁超载对肿瘤标志物CA199水平的影响  

Effect of iron overload on the level of carbohydrate antigen 199 in type 2 diabetes mellitus

作　　者：尚晓静[1] 杜晓明[1] 方涛[1] 张蕊[1] 田凤石[1] Shang Xiaojing;Du Xiaoming;Fang Tao;Zhang Rui;Tian Fengshi

机构地区：[1]天津市第四中心医院内分泌科,天津300140

出　　处：《中华医学杂志》2019年第22期1722-1726,共5页National Medical Journal of China

摘　　要：目的探讨2型糖尿病患者铁超载对肿瘤标志物CA199水平的影响。方法选择2017年1月至2018年6月天津市第四中心医院内分泌科住院的2型糖尿病患者323例作为糖尿病组,年龄(62.4±9.5)岁,男164例,女159例;另取100例健康体检者作为对照组,年龄(61.0±8.1)岁,男52例,女48例。均排除了影响血清铁蛋白、CA199水平的主要疾病,采用电化学发光法测定血清铁蛋白及CA199水平,铁蛋白高于正常范围设为铁超载组。糖尿病组患者根据铁蛋白水平分为铁超载组178例和正常铁蛋白组145例,比较各组间CA199水平,并分析相关性。结果糖尿病组患者血清铁蛋白、CA199水平均高于对照组。糖尿病铁超载组CA199中位数水平(20.7μg/L比15.0μg/L,P<0.001)和超过中间值百分率(53.9%比35.8%,P=0.001)均高于正常铁蛋白组。CA199与糖化血红蛋白、铁超载呈正相关(分别为r=0.280,P<0.001;r=0.210,P<0.001),多重线性回归分析结果显示,铁超载(β′=0.203,P=0.002)和HbA1c(β′=0.202,P=0.001)与血清CA199水平独立相关。结论对2型糖尿病患者,铁超载可能影响血清CA199水平。Objective To investigate the effect of iron overload on tumor marker CA199 in patients with type 2 diabetes mellitus(T2DM).Methods Between January 2017 and June 2018,three hundred and twenty-three hospitalized patients with T2DM in Department of Endocrinology,Tianjin Fourth Central Hospital were selected as diabetes group and another 100 healthy persons as control group.All the participants with major diseases and factors affecting serum ferritin and CA199 level were excluded.Serum ferritin and CA199 levels were measured by chemiluminescence assay.Patients with a ferritin level above the normal range were defined as iron overload group.According to serum ferritin level,178 patients were divided into iron overload group and 145 into normal ferritin group in the diabetes group.The levels of CA199 were compared between iron overload group and normal ferritin group,and the correlation was analyzed.Results The levels of serum ferritin[407.1(346.7)μg/L vs 266.6(201.1)μg/L in males,184.7(133.0)μg/L vs 77.4(64.0)μg/L in females,both P<0.001]and CA199[18.2(19.3)μg/L vs 9.3(9.7)μg/L,P<0.001]in diabetes group were significantly higher than those in control group.Serum CA199 levels in iron overload group were significantly higher than those in normal ferritin group(20.7μg/L vs 15.0μg/L,P<0.001;above intermediate value percent:53.9%vs 35.8%,P=0.001).CA199 was positively correlated with glycosylated hemoglobin(HbA1c)(r=0.280,P<0.001)and iron overload(r=0.210,P<0.001).Multiple linear regression analysis showed that iron overload(β′=0.203,P=0.002)and HbA1c(β′′=0.202,P=0.001)had a significant effect on CA199 level.Conclusion In T2DM patients,iron overload is an important factor affecting serum CA199 level.

关 键 词：糖尿病 2型 铁蛋白质类 抗原 肿瘤相关 碳水化合物 铁代谢障碍 

分 类 号：R587.1[医药卫生—内分泌]