Open AccessDecreased serum CA 19‐9 is associated with improvement of insulin resistance and metabolic control in patients with obesity and type 2 diabetes after Roux‐en‐Y gastric bypass
Author(s) -
Tu Yinfang,
Yu Haoyong,
Zhang Pin,
Di Jianzhong,
Han Xiaodong,
Wu Songhua,
Bao Yuqian,
Jia Weiping
Publication year - 2014
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12200
Subject(s) - medicine , glycated hemoglobin , insulin resistance , type 2 diabetes , endocrinology , diabetes mellitus , insulin , glucose homeostasis , homeostasis , obesity , hemoglobin , homeostatic model assessment , lipid profile
Aims/Introduction Patients with type 2 diabetes are known to show elevated serum levels of carbohydrate antigen 19‐9 ( CA 19‐9). The aim of the present study was to investigate the possible relationships of CA 19‐9 with metabolic control, insulin resistance ( IR ), and pancreatic β‐cell function in patients with obesity and type 2 diabetes who underwent Roux‐En‐Y gastric bypass ( RYGB ). Materials and Methods The present study included 81 healthy volunteers, and 33 patients diagnosed with obesity and type 2 diabetes who underwent RYGB . Anthropometry, serum levels of CA 19‐9, glucose and lipid metabolic profiles, and serum insulin levels were determined at baseline and at 12 weeks after RYGB . Results Changes in CA 19‐9 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 CA 19‐9 were independently and significantly associated with changes in glycated hemoglobin (β = 0.598, P = 0.000), fasting plasma glucose (β = 0.309, P = 0.000) and Homeostasis Model of Assessment‐ IR (β = 0.235, P = 0.010) after adjusting for confounding factors. Conclusions CA 19‐9 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, CA 19‐9 might be a marker with which to evaluate the short‐term effects of glycolipid toxicity on IR in these patients.