The Effect Of Metformin On The Level Of Serum CEA, CA125, CA199 And It Associated Factors In Type 2 Diabetic Patients

ObjectiveThis study is to explore the effect of metformin on the tumor through observing the alterations of serum Carcinoembryonic Antigen(CEA),Carbohydrate antigen 125(CA125)and Carbohydrate antigen 199(CA199)levels between type 2 diabetic patients with and without metformin therapy.MethodsThis is a retrospective study.Type 2 Diabetes Mellitus(T2DM)patients were selected as the subjects in the Department of Endocrinology of the First Affiliated Hospital of Fujian Medical University from MAR 2010 to MAY 2018.The age,onset age,gender,oral hypoglycemic agent and other basic information were collected by reviewing medical records.And lipoprotein-cholesterol(LDL-c),total cholesterol(TG),triglyceride(TC),hemoglobinA1c(HbA1c),CEA,CA125,CA199 and other lab testing data were also collected.Patients were divided into groups based on whether treated with metformin or not(metformin group n=839,non-metformin n=543).Stratified analysis was also performed according to the levels of age,BMI and HbA1c:According to age,they were classified into the youth group(?44 years old),middle-aged group(45-59 years old)and elderly group(?60 years old).Based on Body Mass Index(BMI),they were classified into the underweight group(BMI?18.5kg/m~2),normal BMI group(BMI:18.6~23.9kg/m~2)and overweight group(BMI?24kg/m~2).based on HbA1c,they were divided into glucose well-controlled group(HbA1c<7%)and glucose poorly-controlled group(HbA1c?7%).We compared baseline characteristic and serum tumor markers levels using variance analysis and T test.Simple correlation analysis and multiple linear regression analysis were applied to explore the correlation between tumor markers levels and metformin therapy.Results1.Baseline characteristic:A total of 1382 patients with T2DM(metformin group,n=839,non-metformin,n=543)were included in this study.The mean age of all subject was62.05years.The CEA(3.55±5.8 vs 4.21±4.93),CA125(16.33±31.36 vs 24.47±74.63)and CA199(18.49±20.91 vs 24.98±53.26)levels of metformin group were significantly lower than those of non-metformin group(P<0.05)2.Stratified analysis was also performed according to the levels of age,BMI and HbA1c.(1)Age:In middle-aged patients,the CEA(3.26±2.51 vs 3.87±3.16)?CA125(15.93±32.2 vs 24.72±58.55)?CA199(17.28±22.09 vs 28.3±76.39)levels were all significantly lower than those in non-metformin group,and there was no difference in other age groups.(2)BMI:In underweight group,there were no difference;and in normal BMI group,the serum CA125 level in metformin group was lower than that in non-metformin group(15.38±26.65 vs 23.31±57.49,P<0.05);However in overweight group,the CEA(3.38±4.34 vs 4.23±5.37),CA125(15.12±27.7 vs 25.9±95.04)and CA199(17.2±17.66 vs22.34±36.56)levels in metformin group were significantly lower than those in non-metformin group(P<0.05)(3)HbA1c:In glucose poorly-controlled group,the CA125(16.08±29.91 vs25.13±81.33,P<0.05)and CA199(19.24±21.06 vs 26.34±54.7,P<0.05)levels were significantly lower than those of non-metformin group.However in glucose well-controlled group,the CEA level was significantly lower than that in non-metformin group.(2.55±1.67 vs 3.69±5.8,P<0.05)3.Simple correlation analysis showed that the level of CEA,CA125 and CA199 were negative correlated with metformin.(CEA:R=-0.107,P<0.05;CA125:R=-0.167,P<0.05;CA199:R=-0.116,P<0.05)4.The multiple linear stepwise regression analysis has showed that using metformin had a negative correlation with the level of CEA,CA125 and CA199.ConclusionThere was a negative association of metformin therapy with the serum levels of CEA,CA125 and CA199 in T2DM patients.Furthermore,these relationships between metformin and tumor markers maybe affected by age,BMI and HbA1c.especially for the patients who were middle-aged,glucose poorly-controlled or overweight.Metformin therapy may decrease the serum levels of CEA,CA125 and CA199 in T2DM patients,suggesting that metformin may be a benign intervention on genesis and development of relevant tumors marked by CEA,CA125 and CA199.