Decreased serum CA19-9 is associated with improvement of insulin resistance and metabolic control in patients with obesity and type 2 diabetes after Roux-en-Y gastric bypass.

Aims/Introduction Patients with type 2 diabetes are known to show elevated serum levels of carbohydrate antigen 19-9 ( CA19-9). The aim of the present study was to investigate the possible relationships of CA19-9 with metabolic control, insulin resistance ( IR), and pancreatic β-cell function in patients with obesity and type 2 diabetes who underwent Roux-En-Y gastric bypass ( RYGB). Materials and Methods The present study included 81 healthy volunteers, and 33 patients diagnosed with obesity and type 2 diabetes who underwent RYGB. Anthropometry, serum levels of CA19-9, glucose and lipid metabolic profiles, and serum insulin levels were determined at baseline and at 12 weeks after RYGB. Results Changes in CA19-9 were significantly and positively correlated with changes in fasting plasma glucose ( r = 0.552, P = 0.001), 2-h post-challenge plasma glucose levels ( r = 0.623, P = 0.000), glycated hemoglobin levels ( r = 0.819, P = 0.000), glycated albumin levels ( r = 0.711, P = 0.000), total cholesterol ( r = 0.449, P = 0.009) and the Homeostasis Model of Assessment- IR index ( r = 0.407, P = 0.019). Furthermore, a multiple stepwise regression analysis showed that the changes in serum levels of CA19-9 were independently and significantly associated with changes in glycated hemoglobin (β = 0.598, P = 0.000), fasting plasma glucose (β = 0.309, P = 0.000) and Homeostasis Model of Assessment- IR (β = 0.235, P = 0.010) after adjusting for confounding factors. Conclusions CA19-9 could be an effective indicator of IR, and glycemic and lipid metabolism in patients with obesity and type 2 diabetes after rapid metabolic control by RYGB. Additionally, CA19-9 might be a marker with which to evaluate the short-term effects of glycolipid toxicity on IR in these patients. [ABSTRACT FROM AUTHOR]