老年2型糖尿病病人血清糖类抗原19-9水平及其相关影响因素分析

doi:10.3969/j.issn.1003-9198.2021.03.007

摘要/Abstract

摘要： 目的本研究旨在探讨老年T2DM病人血清糖类抗原19-9(CA19-9)的水平及其影响因素。方法选择2019年3~10月在我院内分泌科住院的536例老年T2DM病人,检测其CA19-9及糖脂代谢相关指标水平,并记录病人使用的降糖药物和微血管并发症发生情况。比较不同CA19-9水平病人的临床特征。采用Spearman相关分析和多元逐步回归分析评价CA19-9水平的影响因素。结果老年T2DM病人CA19-9水平升高的发生率为7.5%。CA19-9＜37 U/mL组和CA19-9≥37 U/mL组间LDL-C、HbA1c、血钙、餐后2 h C肽水平差异有统计学意义(P<0.05或0.01)。使用双胍类药物的病人的CA19-9水平低于使用非双胍类药物的病人(P＜0.01)。Spearman相关分析结果显示,CA19-9与年龄、TC、TG、CRP、HbA1c呈正相关(P<0.05),与血清白蛋白及餐后2 h C肽呈负相关(P<0.05)。多元逐步回归分析结果显示,HbA1c是CA19-9的独立影响因素。结论使用二甲双胍的老年T2DM病人可能具有较低水平的CA19-9。老年T2DM病人的CA19-9水平与血糖控制效果密切相关。

关键词: 2型糖尿病, 老年人, 糖类抗原19-9, 二甲双胍, 糖化血红蛋白

Abstract: Objective To investigate the level and influencing factors of serum carbohydrate antigen 19-9 (CA19-9) in the elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 536 elderly T2DM patients who hospitalized in Department of Endocrinology in our hospital from March to October 2019 were selected. The levels of CA19-9 and related indexes of glucose and lipid metabolism were measured, and the use of hypoglycemic drugs and microvascular complications were recorded. The clinical characteristics of the patients with different CA19-9 levels were compared. The correlation between CA19-9 and related indexes of glucose and lipid metabolism were analyzed by Spearman correlation analysis and multiple stepwise regression analysis. Results The incidence rate of elevated CA19-9 level in the elderly T2DM patients was 7. 5%. There were significant differences in low density lipoprotein cholesterol (LDL-C), glycosylated hemoglobin (HbA1c), calcium and postprandial C-peptide between CA19-9 ＜37 U/mL group and CA19-9≥37 U/mL group (P<0. 05 or P<0. 01). The level of CA19-9 in metformin group was lower than that in non-metformin group (P<0. 05). Spearman correlation analysis showed that the level of CA19-9 was positively correlated with age, total cholesterol, triglyceride, hypersensitive C-reactive protein and HbA1c, but negatively correlated with albumin and postprandial C-peptide (P<0. 05). Multiple stepwise regression model showed that HbA1c was independent influencing factor of CA19-9. Conclusions The elderly patients with T2DM treated with metformin may have lower level of CA19-9. The level of CA19-9 is closely related to the status of blood glucose control in the elderly patients with T2DM.

Key words: type 2 diabetes mellitus, aged, carbohydrate antigen 19-9, metformin, glycosylated hemoglobin

中图分类号:

R 587.1

周绍娟, 鲁翔. 老年2型糖尿病病人血清糖类抗原19-9水平及其相关影响因素分析[J]. 实用老年医学, 2021, 35(3): 237-240.

ZHOU Shao-juan, LU Xiang. Analysis of serum level of CA19-9 and related influencing factors in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2021, 35(3): 237-240.

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