High Prevalence of Abnormal Carcinoembryonic Antigen in Diabetic Inpatients with Poor Glycemic Control

Abstract

Introduction

Higher serum carcinoembryonic antigen (CEA) was found in diabetic patients rather than controls. However, the prevalence of abnormal CEA among diabetic inpatients with a large proportion of poor glycemic control is unclear.

Methods

A total of 385 diabetic inpatients were included in this study. We collected information from a large clinical database. Patients with malignant tumors were excluded by examination and follow-up.

Results

We found a surprisingly high prevalence (14.3%) of diabetic inpatients with CEA above normal. The proportion of patients with abnormal CEA was significantly different in subgroups with different blood glucose levels, 20.4% in the HbA1c ≥ 9% group, and 8.5% in the HbA1c < 9%, p = 0.000. We found that the CEA levels were correlated with age, body mass index and HbA1c. The regression coefficient of HbA1c was the highest, B = 0.284, p = 0.000. We also found that the CEA levels were higher in diabetic inpatients with BMI < 24 kg/m2 than the overweight or obesity patients. There was a significant difference in the insulin level and C peptide level between the elevated CEA group and the non-elevated CEA group.

Conclusion

The elevation of CEA is common in diabetic inpatients, especially those with poor hyperglycemia controlled (HbA1c ≥ 9%). The underlying mechanism may be related to glucose toxicity.

Keywords:

• diabetic patients
• CEA
• carcinoembryonic antigen
• hyperglycemic

Clinical Perspectives

Diabetes-related health expenditures are very high. Diabetic inpatients are routinely screened for tumor markers. Our study revealed that the elevation of CEA was common in diabetic inpatients, especially those with poor hyperglycemia controlled (HbA1c ≥ 9%). The CEA level was significantly correlated with HbA1c. Our study indicated that it was better to re-check the CEA level after glucotoxic remission instead of extensive screening or trauma tests for cancer. Clinicians’ understanding of this phenomenon may avoid waste of medical resources and unnecessary panic of patients.

Data Sharing Statement

Data are openly available in a public repository that issues datasets with DOIs. The data that support the findings of this study are openly available in Figshare. DOI:10.6084/m9.figshare.19848850.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This work was supported by the grants from the project of science and technology of Jinhua (2022-3-029).