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Serum CA 19-9 and risk of incident diabetes in middle-aged and elderly Chinese: a prospective cohort study

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Abstract

Aims

Carbohydrate antigen (CA) 19-9 is a tumor marker for gastrointestinal and pancreatic cancers. Previous studies found that CA 19-9 was elevated in patients with diabetes, but little is known about its relationship with diabetes risk in prospective studies. Our objective was to evaluate the association between serum CA 19-9 and the risk of incident diabetes in Chinese population.

Methods

Data were obtained from a prospective cohort study among 2391 middle-aged and elderly Chinese with a median follow-up of 3.8 years. The measurement for the study outcome was incident diabetes.

Results

Compared with individuals in the lowest quartile, those in the highest quartile of CA 19-9 had significantly higher incidence of diabetes (12.54 vs. 8.86%, P = 0.04). In the fully adjusted logistic regression model, compared with the lowest quartile, the highest quartile of CA 19-9 was significantly associated with 58% increased risk of incident diabetes [odds ratio (OR), 95% confidence interval (CI) 1.58, 1.02–2.44]. Stratified analysis suggested that the increased risk was seen only in women (OR, 95% CI 1.96, 1.10–3.48), or participants aged ≥65 (OR, 95% CI 2.32, 1.03–5.19), or those with body mass index ≥24 (OR, 95% CI 2.09, 1.20–3.63), or current nondrinkers (OR, 95% CI 1.79, 1.09–2.92), or those with impaired glucose regulation (IGR) (OR, 95% CI 2.49, 1.33–4.67). Significant interaction was detected between IGR and serum CA 19-9 (P for interaction <0.0001).

Conclusions

Serum CA 19-9 is associated with a significantly increased risk of diabetes among the middle-aged and elderly Chinese population. Further investigations are needed to confirm this association and disclose potential mechanisms.

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Acknowledgements

The authors thank the field working staff for their contribution and the participants for their cooperation. This study was supported by Grants from the National Natural Science Foundation of China (81170719, 81370960, and 81670795), the Ministry of Science and Technology of the People’s Republic of China (2015BAI12B14, 2015BAI12B02). Jieli Lu was supported by ‘Chenxing Plan’ of Shanghai Jiaotong University, Shuguang Program (15SG15), and Gaofeng Clinical Medicine Grant Support (20152202) from Shanghai Municipal Education Commission.

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    Authors and Affiliations

    1. National Clinical Research Center for Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui Jin 2nd Road, Shanghai, 200025, China

      Rui Du, Wanwan Sun, Lin Lin, Jichao Sun, Kui Peng, Yu Xu, Min Xu, Yuhong Chen, Yufang Bi, Weiqing Wang & Jieli Lu

    2. Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

      Donghui Li

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    1. Rui Du
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    Correspondence to Jieli Lu.

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    Ethical standard

    The study was approved by the Institutional Review Board of Rui Jin Hospital affiliated with Shanghai Jiao Tong University School of Medicine.

    Human and Animal Rights disclosure

    All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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    Informed consent was obtained from all patients for being included in the study.

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    Managed by Massimo Federici.

    Rui Du, Wanwan Sun and Lin Lin have contributed equally to this work.

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    Du, R., Sun, W., Lin, L. et al. Serum CA 19-9 and risk of incident diabetes in middle-aged and elderly Chinese: a prospective cohort study. Acta Diabetol 54, 201–208 (2017). https://doi.org/10.1007/s00592-016-0937-y

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