Association of Circulating Carbohydrate Antigen 19-9 Level with Type 2 Diabetic Kidney Disease in Chinese Adults: A Cross-Sectional Study

Abstract

Pijun Yan,1– 5 Jia Li,1– 5 Yi Zhang,1– 5 Xiaofang Dan,1– 5 Xian Wu,1– 5 Xing Zhang,1– 5 Yuxia Yang,1– 5 Xiping Chen,6 Shengxi Li,6 Pan Chen,1– 5 Qin Wan,1– 5 Yong Xu1– 5 1Department of Endocrinology and Metabolism, the Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China; 2Metabolic Vascular Disease Key Laboratory of Sichuan Province, Luzhou, People’s Republic of China; 3Sichuan Clinical Research Center for Diabetes and Metabolism, Luzhou, People’s Republic of China; 4Sichuan Clinical Research Center for Nephropathy, Luzhou, People’s Republic of China; 5Cardiovascular and Metabolic Diseases Key Laboratory of Luzhou, Luzhou, People’s Republic of China; 6Clinical medical College, Southwest Medical University, Luzhou, People’s Republic of ChinaCorrespondence: Pijun Yan, Department of Endocrinology and Metabolism, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China, Tel/Fax [phone], Email [email protected]: Very few and conflicting data are available regarding the correlation between circulating carbohydrate antigen 19-9 (CA19-9) levels and diabetic kidney disease (DKD) and its components including albuminuria and a low estimated glomerular filtration rate (eGFR). This study aimed to examine the association of circulating CA19-9 and DKD in Chinese patients with type 2 diabetes mellitus (T2DM).Methods: A total of 402 hospitalized T2DM patients between September 2017 and December 2021 were included in this cross-sectional study. There were 224 and 178 subjects in non-DKD and DKD groups, respectively. Serum CA19-9 was measured by chemiluminescence method, and its potential relationship with DKD was evaluated by multivariate logistic regression and correlation analyses, and receiver operating characteristic (ROC) curve analysis.Results: T2DM patients with DKD had significantly higher serum CA19-9 levels than those without, and serum CA19-9 levels were positively related to urinary albumin-to-creatinine ratio and negatively to eGFR (P< 0.01). Multivariate regression analysis revealed that serum CA 19-9 was an independent factor of DKD [odds ratio (OR), 1.018; 95% confidence interval (CI), 1.002– 1.035; P< 0.05]. Moreover, an increased progressively risk of DKD with an increase in serum CA19-9 quartiles was observed (P for trend < 0.001), and T2DM patients in the highest serum CA19-9 quartile were associated with an increased likelihood of DKD when compared to those in the lowest quartile (OR: 2.936, 95% CI 1.129– 7.633, P< 0.05). Last, the analysis of ROC curves suggested that serum CA 19-9 at a cut of 25.09 U/mL resulted in the highest Youden index with sensitivity 43.8% and 75.4% specificity to predict the presence of DKD.Conclusion: These results showed that high circulating CA19-9 was related to DKD and may serve as a useful biomarker of DKD in hospitalized Chinese T2DM patients.Keywords: carbohydrate antigen 19-9, urinary albumin-to-creatinine ratio, diabetic kidney disease, estimated glomerular filtration rate, Chinese population

Keywords

• carbohydrate antigen 19-9
• urinary albumin-to- creatinine ratio
• diabetic kidney disease
• estimated glomerular filtration rate
• chinese population