The High Prevalence of Short-Term Elevation of Tumor Markers Due to Hyperglycemia in Diabetic Patients

Figures & data

Table 1 Basic Demographic and Clinical Characteristics of Participants

Variables	Male (n=60)	Female (n=41)	p
Age (years)	53.8±15.4	61.2±10.2	0.009*
Duration of diabetes (years)	6.0±4.4	8.0±3.5	0.017*
Status of smoking(%)			<0.001*
Smoking cessation	5/60 (8.3%)	1/41 (2.4%)
Smoking	17/60 (28.3%)	1/41 (2.4%)
No smoking	38/60 (63.3%)	39/41 (95.1%)
Status of drinking(%)			0.005*
Drinking cessation	9/60 (15.0%)	3/41 (7.3%)
Drinking	22/60 (36.7%)	5/41 (12.2%)
No drinking	29/60 (48.3%)	33/41 (80.5%)
BMI (kg/m^2)	25.9±4.0	25.1±4.1	>0.05
HbA1c (%)	9.2±2.3	9.1±1.6	>0.05
Blood pressure (mmHg)			>0.05
Reached control target (<130/80)	44/60 (73.3%)	30/41 (73.2%)
Not met control target (≥130/80)	16/60 (26.7%)	11/41 (26.8%)
Total cholesterol (mmol/l)			>0.05
Reached control target (<4.5)	23/60 (38.3%)	15/41 (36.6%)
Not met control target (≥4.5)	37/60 (61.7)	26/41 (63.4%)
Triglycerides (mmol/l)			>0.05
Reached control target (<1.7)	27/60 (45.0%)	19/41 (46.3%)
Not met control target (≥1.7)	33/60 (55.0%)	22/41 (53.7%)

Note: *p value less than 0.05 was considered statistically significant.

Figure 1 The prevalence of diabetic inpatients with elevation of tumor markers.

Abbreviations: CEA, carcinoembryonic antigen; AFP, alpha-fetoprotein; NSE, neuron-specific enolase; CYFRA 21–1, cytokeratin 19 fragment; CA19-9, sugar chain antigen 19–9; CA125, sugar chain antigen 125; CA15-3, carbohydrate antigen 15–3; CA72-4, sugar chain antigen 72–4; SCC, squamous-cell carcinoma.

Figure 2 The rate of diabetic inpatients with elevation tumor markers that returned to normal after controlling blood glucose.

Abbreviations: CEA, carcinoembryonic antigen; NSE, neuron-specific enolase; CYFRA 21–1, cytokeratin 19 fragment.

Figure 3 The proportion of diabetic patients with elevation of CYFRA 21–1 between the two groups, the HbA1c ≤8% group and the HbA1c >8% group (p = 0.244).

Abbreviation: CYFRA 21–1, cytokeratin 19 fragment.

Table 2 Comparison Between the Elevated CYFRA 21–1 Group and the Normal CYFRA 21–1 Group

Variables	The Elevated CYFRA 21–1 Group (n=55)	The Normal CYFRA 21–1 Group (n=46)	p
Age (years)	61.1±10.9	51.7±15.4	0.001*
Duration of diabetes (years)	8.2±4.4	5.1±3.1	<0.001*
Gender (female proportion)	25/55	16/46	>0.05
BMI (kg/m^2)	25.01±3.15	26.30±4.77	>0.05
HbA1c (%)	8.79±2.10	9.53±1.95	>0.05
Blood pressure (mhm)			>0.05
Reached control target (<130/80)	40/55	34/46
Not met control target (≥130/80)	15/55	12/46
Total cholesterol (mmol/l)			>0.05
Reached control target (<4.5)	20/55	18/46
Not met control target (≥4.5)	35/55	28/46
Triglycerides (mmol/l)			>0.05
Reached control target (<1.7)	26/55	20/46
Not met control target (≥1.7)	29/55	26/46
Serum creatinine (umol/l)	88.5±16.1	81.2±14.6	>0.05
ALT(U/l)	34.5±20.6	36.8±28.2	>0.05

Note: *p value less than 0.05 was considered statistically significant.

Abbreviations: ALT, alanine aminotransferase; BMI, body mass index; HbA1c, glycosylated hemoglobin.

Table 3 Comparison Between the Group with Elevated Tumor Markers Except CYFRA 21–1 and the Group with Normal Tumor Markers

Variables	The Group with Elevated Tumor Markers (n=40)	The Group with Normal Tumor Markers (n=61)	p
Age (years)	55.4±15.8	57.7±12.6	>0.05
Duration of diabetes (years)	6.2±4.1	7.2±4.2	>0.05
Gender (female proportion)	14/40	27/61	>0.05
BMI (kg/m^2)	25.7±4.1	25.5±4.0	>0.05
HbA1c (%)	10.3±2.1	8.4±1.7	<0.001*
Blood pressure (mmHg)			>0.05
Reached control target (<130/80)	26/40	48/61
Not met control target (≥130/80)	14/40	13/61
Total cholesterol (mmol/l)			>0.05
Reached control target (<4.5)	13/40	25/61
Not met control target (≥4.5)	27/40	36/61
Triglycerides (mmol/l)			>0.05
Reached control target (<1.7)	17/40	29/61
Not met control target (≥1.7)	23/40	32/61
Serum creatinine (umol/l)	86.2±17.6	84.5±16.8	>0.05
ALT(U/l)	34.0±21.2	36.6±29.5	>0.05

Notes: *p value less than 0.05 was considered statistically significant. CYFRA 21–1 was excluded from data analysis.

Table 4 Comparison Between the Group with Elevation of CEA and the Group with Normal CEA

Variables	The Group with Elevated CEA (n=16)	The Group with Normal CEA (n=85)	p
Age (years)	58.9±12.8	56.4±14.2	>0.05
Duration of diabetes (years)	6.4±3.9	6.9±4.2	>0.05
Gender (female proportion)	4/16	37/85	>0.05
BMI (kg/m^2)	24.1±3.0	25.9±4.1	>0.05
HbA1c (%)	10.8±1.9	8.8±1.9	<0.001*
Blood pressure (mmHg)			>0.05
Reached control target (<130/80)	11/16	63/85
Not met control target (≥130/80)	5/16	22/85
Total cholesterol (mmol/l)			>0.05
Reached control target (<4.5)	6/16	32/85
Not met control target (≥4.5)	10/16	53/85
Triglycerides (mmol/l)			>0.05
Reached control target (<1.7)	7/16	39/85
Not met control target (≥1.7)	9/16	46/85
Serum creatinine (umol/l)	90.2±22.7	84.2±16.9	>0.05
ALT(U/l)	33.2±16.2	35.9±30.1	>0.05

Note: *p value less than 0.05 was considered statistically significant.

Table 5 Comparison Between the Group with Elevation of Carbohydrate Antigen and the Group with Normal Carbohydrate Antigen

Variables	The Group with Elevated Carbohydrate Antigen (n=20)	The Group with Normal Carbohydrate Antigen (n=81)	p
Age (years)	56.9±15.7	56.8±13.5	>0.05
Duration of diabetes (years)	7.0±4.4	6.7±4.1	>0.05
Gender (female proportion)	8/20	33/81	>0.05
BMI (kg/m^2)	25.3±2.8	25.7±4.3	>0.05
HbA1c (%)	10.1±1.9	8.9±2.1	0.025*
Blood pressure (mmHg)			>0.05
Reached control target (<130/80)	14/20	60/81
Not met control target (≥130/80)	6/20	21/81
Total cholesterol (mmol/l)			>0.05
Reached control target (<4.5)	7/20	31/81
Not met control target (≥4.5)	13/20	50/81
Triglycerides(mmol/l)			>0.05
Reached control target (<1.7)	8/20	38/81
Not met control target (≥1.7)	12/20	43/81
Serum creatinine (umol/l)	89.3±20.9	85.1±18.2	>0.05
ALT(U/l)	34.9±22.7	35.7±31.2	>0.05

Note: *p value less than 0.05 was considered statistically significant.

Figure 4 Compare the proportion of diabetic inpatients with elevation of tumor markers between the high blood glucose group and the lower blood glucose group.

Notes: 101 diabetic patients were divided into two groups according to HbA1c, HbA1c≤8% group and HbA1c>8% group. All p values were less than 0.05. Carbohydrate antigen including carbohydrate antigen 19–9, 125, 15–3, and carbohydrate antigen 72–4.

Abbreviations: CYFRA 21–1, cytokeratin 19 fragment; CEA, carcinoembryonic antigen.