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

作者：Tu, Yinfang; Yu, Haoyong; Zhang, Pin; Di, Jianzhong; Han, Xiaodong; Wu, Songhua; Bao, Yuqian; Jia, Weiping^*

来源：Journal of Diabetes Investigation, 2014, 5(6): 694-700.

DOI：10.1111/jdi.12200

• Carbohydrate antigen 19-9
• Insulin resistance
• Obesity

Aims/IntroductionPatients 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 -cell function in patients with obesity and type 2 diabetes who underwent Roux-En-Y gastric bypass (RYGB).
Materials and MethodsThe 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 12weeks after RYGB.
ResultsChanges 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 (=0.598, P=0.000), fasting plasma glucose (=0.309, P=0.000) and Homeostasis Model of Assessment-IR (=0.235, P=0.010) after adjusting for confounding factors.
ConclusionsCA19-9 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.

• 出版日期2014-11
• 单位上海交通大学; 上海市临床检验中心