Relationship between CA 19-9 levels and glucose regulation in a middle-aged and elderly Chinese population

Abstract

Objective: To investigate carbohydrate antigen (CA) 19-9 levels in subjects with different glucose regulation status and assess the relationship between CA 19-9 and glucose regulation status in a Chinese population aged 40 years and older.

Methods: A total of 2792 participants aged 40 years or older with no history of diabetes were enrolled in the present study from the Songnan region, Shanghai, China. Each participant received a two-point (at 0 and 2 hours) 75-g oral glucose tolerance test and measurements of hemoglobin A1c (Hb(A1c)) and CA 19-9 were made.

Results: The CA 19-9 levels increased gradually from normal glucose regulation to impaired glucose regulation to new-onset diabetic patients (8.81, 9.84, and 11.08 U/mL, respectively, P < 0.0001 for trend). In new-onset diabetic patients, the CA 19-9 levels were positively and significantly associated with fasting plasma glucose (r = 0.20, P < 0.0001), 2 h post-load plasma glucose (r = 0.17, P = 0.0007), and Hb(A1c) (r = 0.19, P = 0.0001). Meanwhile, patients with new-onset diabetes had 3.31-fold (OR, 4.31; 95% CI, 2.00-9.32) increased higher odds ratio of elevated CA 19-9 as compared with those with normal glucose regulation after adjustments for confounders.

Conclusions: The CA 19-9 levels were significantly higher in diabetic and patients with impaired glucose regulation compared with subjects with normal glucose regulation. Diabetic status was independently associated with elevated CA 19-9. These results imply that CA 19-9 might also relate to the endocrine function of the pancreas.