■本研究的目的是研究2型糖尿病(T2DM)伴微量白蛋白尿患者血清肿瘤标志物的变化,并分析肿瘤标志物与微量白蛋白尿的关系。
■共有956名40-70岁的T2DM患者在内分泌科住院,新华医院,中国,上海交通大学医学院附属,于2018年1月至2020年12月注册。样本包括313名具有微量白蛋白尿的T2DM患者和643名具有正常尿微量白蛋白水平的T2DM患者。2型糖尿病伴微量白蛋白尿患者血清肿瘤标志物的变化,我们使用多因素logistic回归分析了血清肿瘤标志物类别中微量白蛋白尿的风险.
■血清CEA,CA199,CA125,CA153,CA211,SCC,有微量白蛋白尿的T2DM患者的CA242和CA50水平明显高于无微量白蛋白尿的T2DM患者,而微量白蛋白尿组血清AFP水平较低(P<0.05)。在调整混杂因素后,血清CEA,在T2DM中,CA211和SCC与微量白蛋白尿独立相关。ROC曲线用于估计微量白蛋白尿的肿瘤标志物的截止点。以截止点下的值作为参考,CEA的值,CA211和SCC高于截止点表明微量白蛋白尿的风险显著较高。CEA升高对微量白蛋白尿的OR为2.006(95CI1.456-2.765),CA211增加对微量白蛋白尿的OR为1.505(95CI1.092-2.074),SCC增加对微量白蛋白尿的OR为1.958(95CI1.407-2.724)。
■几种血清肿瘤标志物与T2DM患者微量白蛋白尿有关。血清肿瘤标志物如CEA,SCC,CA211可能提示早期糖尿病肾病,特别是当组合升高时。
The objective of this study was to investigate changes in serum tumor markers in type 2 diabetes mellitus (T2DM) with microalbuminuria and analyze the relationship between tumor markers and microalbuminuria.
A total of 956 T2DM patients aged 40-70 years hospitalized in the Department of Endocrinology, Xinhua Hospital,
China, affiliated with Shanghai Jiaotong University School of Medicine, were enrolled from January 2018 to December 2020. The sample comprised 313 T2DM patients with microalbuminuria and 643 T2DM patients with normal urinary microalbumin levels. After assessing the changes in serum tumor markers in T2DM with microalbuminuria, we analyzed the risk of microalbuminuria by the serum tumor marker category using multiple logistic regression analysis.
Serum CEA, CA199, CA125, CA153, CA211, SCC, CA242, and CA50 levels were significantly higher in T2DM patients with microalbuminuria than in those without microalbuminuria, while serum AFP levels were lower in the microalbuminuria group (P < 0.05). Following adjustment of confounders, serum CEA, CA211, and SCC were independently associated with microalbuminuria in T2DM. An ROC curve was used to estimate the cutoff point of tumor markers for microalbuminuria. Taking the values under the cutoff points as a reference, values for CEA, CA211, and SCC above the cutoff points indicated a significantly high risk of microalbuminuria. The OR of increased CEA for microalbuminuria was 2.006 (95%CI 1.456-2.765), the OR of increased CA211 for microalbuminuria was 1.505 (95%CI 1.092-2.074), and the OR of increased SCC for microalbuminuria was 1.958 (95%CI 1.407-2.724).
Several serum tumor markers were related to microalbuminuria in T2DM. Serum tumor markers such as CEA, SCC, and CA211 may indicate early diabetic nephropathy, particularly when elevated in combination.