Analysis Of The Relationship And Related Influencing Factors Between The Level Of Tumor Markers And Diabetic Complications In Patients With Type 2 Diabetes Mellitus

BackgroundDiabetes affects an estimated 463 million people worldwide,China has 116 million people with diabetes,making it the largest diabetic country in the world.Chronic hyperglycemia can lead to chronic injury and dysfunction of various tissues and organs,leading to complications of diabetes.The American Diabetes Association(ADA)and the American Cancer Society(ACS)jointly issued a consensus in 2010,it pointed out that type 2 Diabetes mellitus patients have a higher risk of cancer.Tumor markers can be used in the clinical diagnosis of tumor diseases and the evaluation of treatment prognosis.In order to understand the relationship between the level of tumor markers and the complications of diabetes,we conducted this study.ObjectiveStudy on the correlation between serum levels of carbohydrate antigen 199(CA199),carcinoembryonic antigen(CEA),carbohydrate antigen 153(CA153),carbohydrate antigen 125(CA125),alpha-fetoprotein(AFP)and diabetic complications in patients with type 2 diabetes mellitus.MethodsSelected 378 diabetic patients from january 2018 to june 2019 in the endocrine department of the second affiliated hospital of luohe medical college as the study subjects.Among them,type 1 diabetes mellitus(T1DM)54 cases,type 2 diabetes mellitus(T2DM)324 cases,another 68 people selected as the normal control group in the same pe-riod.The tumor markers were observed in three groups: CA199,CEA,CA153,CA125,AFP and Body Mass Index(BMI),waist-to-hip ratio(WHR),and blood pressure(BP),fasting plasma glucose(FPG),C-peptide,glycosylated hemoglobin(HbA1c),urinary microalbumin(M-ALB),triglyceride(TG)levels.According to the complications of T2 DM,the patients were further divided into the non-complications group(121 cases),the single complication group(108 cases)and the multiple complications group(95 cases).Firstly,the patients with and without complications were analyzed by univariate and logistic regression,then the patients were grouped into single and multiple complications to analysis the risk factors leading to their occurrence.ResultsThe results of three groups of univariate ANOVA showed that the differences of CA199,CEA,CA153,CA125 and AFP were statistically significant(P<0.05).After multiple tests of tumor markers in the three groups,the LSD-t results showed that T1 DM,T2DM,control group CA199,CEA,CA153,CA125,AFP were higher in the T2 DM group than in the T1 DM group,and both the T2 DM group and the T1 DM group were higher than the control group and the differences were statistically significant(P<0.05).According to pearson correlation analysis,the tumor markers CA199,CEA,CA153,CA125,AFP and BMI,WHR,BP,FPG,C peptide,HbA1 c,M-ALB,TG showed significant positive correlation.One factor ANOVA of CA199,CEA,CA153,CA125,AFP showed that T2 DM patients with single and multiple complications were higher than those without complications,and the difference was statistically significant(P<0.05).Comparison of post-test results of tumor marker CA199 in patients with single complication and multiple complications showed that patients with multiple complications were higher than those with single complication,and the difference was statistically significant(P<0.05).There was no significant difference between CEA,CA153,CA125 and AFP(P>0.05).Compared with of CA199,CEA,CA153,CA125 and AFP showed that patients with single and multiple complica-tions were higher than those without complications,and the difference was statistically significant(P<0.05).Univariate analysis of variance showed that there was no significant difference in tumor markers CA199,CEA,CA153,CA125,AFP among patients with different single complications(P>0.05).After LSD-t test,there was no significant difference in comparison of CA199,CEA,CA153,CA125 and AFP among patients with single complication(P>0.05).The results of univariate analysis showed that smoking,family history of diabetes,hypertension,coronary heart disease,hyperlipidemia,course of disease,CA199,CEA,CA153,CA125,AFP,systolic blood pressure,diastolic blood pressure,FPG,C peptide,HbA1 c,M-ALB and TG were the influencing factors of single and multiple complications in T2 DM patients.Course of disease,CA199,systolic and diastolic blood pressure,family history of diabetes,hypertension,coronary heart disease and hyperlipidemia are independent risk factors for multiple complications.Course of disease,CA199,CEA,CA153,CA125,systolic blood pressure,smoking,family history of diabetes and hyperlipidemia are independent risk factors leading to a single complication in patients.Consequence1.The levels of CA199,CEA,CA153,CA125 and AFP in patients with type 2 diabetes mellitus are higher than those in patients with type 1 diabetes mellitus and normal population.2.The levels of CA199,CEA,CA153,CA125 and AFP in T2 DM patients with complications are higher than those without complications.3.CA199 is an independent risk factor for multiple complications in patients with type 2 diabetes mellitus.4.CA199,CA153 and CA125 are independent risk factors for T2 DM patients with single complication.