Correlation between glucose time-in-range and tumor markers in type 2 diabetes mellitus patients

Abstract

Objective To investigate the relationship between glucose time in range（TIR） and serum tumor markers in patients with type 2 diabetes mellitus（T2DM）. Methods The data of 300 T2DM patients treated in the Second Affiliated Hospital of Zhengzhou University from March 2021 to March 2022 were selected. According to the 14 days of continuous glucose monitoring, the patients were divided into unqualified group（TIR≤70%， n=159） and qualified group（TIR＞70%, n=141）. The unqualified group was divided into poor-control subgroup（TIR≤40%） and non-standard subgroup（TIR>40%-70%）. The qualified group was divided into standard subgroup（TIR>70%-<85%） and excellent group（TIR≥85%）. The clinical data of patients, including gender, age, course of disease, percentages of glucose TIR, time above range（TAR）and time below range（TBR）, fasting plasma glucose（FPG）,fasting C-peptide, glycated hemoglobin A1c（HbA1c）, carcinoembryonic antigen (CEA), carbohydrate antigen (CA)199, CA724, CA125, alpha-fetoprotein（AFP）, cytokeratin 19 fragment（CYF211） and total prostate-specific antigens（tPSA） and free prostate-specific antigens（fPSA） of male patients were collected. Results The course of disease, HbA1c, CEA, CYF211 and TPSA levels in unqualified group were significantly higher than those in qualified group, while C-peptide level was lower than that in qualified group（P<0.05）. Among the four subgroups, the courses of disease in poor-control subgroup and non-standard subgroup were significantly longer than those in standard subgroup and excellent subgroup（P<0.05）. HbA1c and FPG levels in poor-control subgroup were significantly higher than those in the other subgroups, and HbA1c in non-standard subgroup was statistically higher than that in excellent subgroup（P<0.05）. AFP in poor-control subgroup was significantly higher than that in the other subgroups（P<0.05）, and CEA in poor-control subgroup was higher than that in non-standard subgroup and standard subgroup（P<0.05）. CYF211 in poor-control group was higher than that in standard and excellent groups and it was also higher in non-standard group compared than that in standard group（P<0.05）. Correlation analysis showed that TIR was negatively correlated with CEA (r=-0.14, P<0.05 ) and CYF211 (r=-0.17, P<0.05), and there were positive correlations between TAR and CEA (r=0.19, P<0.01), CYF211 (r=0.17, P<0.05) and AFP (r=0.13, P<0.05). Conclusion In T2DM patients, increasing the percentage of TIR and reducing the percentage of TAR can reduce the risk of elevated tumor markers, while TBR has no significant impact on tumor markers.

Keywords

• type 2 diabetes mellitus
• time in range
• glucose fluctuation
• tumor marker
• continuous glucose monitoring
• carcinoembryonic antigens