CAJ | 학술논문

目的探索二甲双胍对肝肾功能正常的2型糖尿病患者血清糖类抗原125 (CA125)水平的影响及其相关因素.方法入选2011年3月-2012年3月上海市第六人民医院内分泌代谢科住院的1 136例2型糖尿病患者,按性别、年龄、体质指数分组,根据是否服用二甲双胍进一步分为双胍组和非双胍组,比较各组间血清CA125水平及其他生化特征,分析影响血清CA125水平的因素.结果总体人群中双胍组血清CA125水平明显低于非双胍组[10.51(8.18,13.80)比11.93(9.05,15.52),P＜0.01].30 ～39岁和50 ～59岁的男性患者及≥50岁的女性患者用药后CA125水平明显下降(P＜0.05).与非双胍组相比,双胍治疗后体重正常的患者和肥胖的女性患者CA125水平下降更为明显,差异有统计学意义(P＜0.05).相关分析表明CA125与性别、糖化血红蛋白(HbA1c)、糖化血清白蛋白(GA)等呈正相关(P＜0.05),而与应用二甲双胍、血清肌酐(SCr)呈负相关(P＜0.01).多元逐步回归分析的结果揭示GA、二甲双胍、性别、TG是血清CA125的独立影响因素(均P＜0.05).结论 2型糖尿病患者应用二甲双胍治疗与血清CA125水平降低有关,尤其是女性患者.
목적 탐색이갑쌍고대간신공능정상적2형당뇨병환자혈청당류항원125 (CA125)수평적영향급기상관인소.방법 입선2011년3월-2012년3월상해시제륙인민의원내분비대사과주원적1 136례2형당뇨병환자,안성별、년령、체질지수분조,근거시부복용이갑쌍고진일보분위쌍고조화비쌍고조,비교각조간혈청CA125수평급기타생화특정,분석영향혈청CA125수평적인소.결과 총체인군중쌍고조혈청CA125수평명현저우비쌍고조[10.51(8.18,13.80)비11.93(9.05,15.52),P＜0.01].30 ～39세화50 ～59세적남성환자급≥50세적녀성환자용약후CA125수평명현하강(P＜0.05).여비쌍고조상비,쌍고치료후체중정상적환자화비반적녀성환자CA125수평하강경위명현,차이유통계학의의(P＜0.05).상관분석표명CA125여성별、당화혈홍단백(HbA1c)、당화혈청백단백(GA)등정정상관(P＜0.05),이여응용이갑쌍고、혈청기항(SCr)정부상관(P＜0.01).다원축보회귀분석적결과게시GA、이갑쌍고、성별、TG시혈청CA125적독립영향인소(균P＜0.05).결론 2형당뇨병환자응용이갑쌍고치료여혈청CA125수평강저유관,우기시녀성환자.
Objective To explore the effects of metformin therapy on serum carbohydrate antigen 125 (CA125) levels and its related factors in type 2 diabetics with normal liver and kidney function.Methods Serum CA125 level was measured and compared for a total of 1 136 type 2 diabetics.They were assigned into groups according to gender,age and body mass index (BMI) and subgroups according to metformin dosing.Associations between CA125 and other variables were assessed with Spearman or Pearson's correlation and multiple stepwise regression analysis.Results The CA125 level of metformin group was significantly lower than that of non-metformin group (10.51(8.18,13.80) vs 11.93(9.05,15.52) U/ml,P ＜ 0.01).The CA125 levels of males aged 30-39 and 50-59 as well as females aged over 50 remarkably decreased after metformin dosing (all P ＜ 0.05).The difference of CA125 level between metformin and nonmetformin groups in patients with normal BMI and obese females reached statistical significance (all P ＜0.05).The correlation analysis showed that serum CA125 level was positively associated with gender,HbA1 c,glycated serum albumin,triglyceride,total cholesterol (P ＜ 0.05),but negatively with metformin and creatinine (P ＜ 0.01).Multiple stepwise regression analysis further revealed that GA,metformin dosing,gender and total glycerides were independent influencing factors of CA125 concentrations (all P ＜ 0.05).Conclusion Metformin dosing is an independent associated factor of serum CA125 levels reduction in type 2 diabetics,especially females.