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Exp Clin Endocrinol Diabetes 2022; 130(06): 400-405
DOI: 10.1055/a-1532-4576
Article

Elevated Serum Levels of Carbohydrate Antigen 72–4 in Diabetic Kidney Disease

Lei Shi‡
1   Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
,
Jiali Meng‡
1   Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
,
Bin Zhang
1   Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
,
Jiandong Chen
1   Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
,
Jianzhong Chen
1   Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
,
Jue Zhang
1   Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
› Author AffiliationsSupported by: National Natural Science Foundation of China 82074185
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Abstract

The aim of this study was to determine whether carbohydrate antigen 72–4 (CA72–4) is elevated in diabetic kidney disease (DKD), and examine the association between urinary albumin-to-creatinine ratio (UACR) and CA72–4 in patients with type 2 diabetes mellitus (T2DM). Non-dialysis patients with T2DM (n=296) and 90 healthy controls were recruited in this study. CA72–4 level was measured by electrochemiluminescence immunoassay. DKD was defined as UACR≥ 30 mg/g in the absence of a urinary infection or other renal diseases. We found that patients with DKD had significantly higher serum CA72–4 levels compared to those with normoalbuminuria and healthy controls. Positive rates of CA72–4 increased gradually and markedly from normoalbuminuria to microalbuminuria and to macroalbuminuria in diabetic patients (7.5, 11.2, and 17.4%, respectively; P for trend< 0.05). CA72–4 also showed a positive correlation with UACR (r=0.288, P< 0.01). Logistic regression analysis revealed the association of increased UACR with an increased odds ratio of elevation of CA72–4 levels (P for trend< 0.05) after multivariable adjustment. In conclusion, serum levels of CA72–4 increase abnormally with the increase in urinary albumin excretion, which affects the specificity of diagnosis of malignancies. An appropriate interpretation of CA72–4 is essential to prevent unnecessary and even hazardous diagnostic procedures in patients with T2DM.

Key words

carbohydrate antigen 72–4 - diabetic kidney disease - urinary albumin-to-creatinine ratio


Publication History

Received: 02 February 2021
Received: 05 June 2021

Accepted: 15 June 2021

Article published online:
04 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Li Y, Teng D, Shi X. et al. Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association: national cross sectional study. BMJ 2020; 369: m997
    CrossrefPubMedSearch in Google Scholar
  • 2 Chen C, Chen Q, Nie B. et al. Trends in bone mineral density, osteoporosis, and osteopenia among U.S. adults with prediabetes, 2005-2014. Diabetes Care 2020; 43: 1008-1015
    CrossrefPubMedSearch in Google Scholar
  • 3 Noto H, Goto A, Tsujimoto T. et al. Latest insights into the risk of cancer in diabetes. J Diabetes Investig 2013; 4: 225-232
    CrossrefPubMedSearch in Google Scholar
  • 4 Qi J, He P, Yao H. et al. Cancer risk among patients with type 2 diabetes: A real-world study in Shanghai, China. J Diabetes 2019; 11: 878-883
    CrossrefPubMedSearch in Google Scholar
  • 5 Giovannucci E, Harlan DM, Archer MC. et al. Diabetes and cancer: A consensus report. Diabetes Care 2010; 33: 1674-1685
    CrossrefPubMedSearch in Google Scholar
  • 6 Colcher D, Hand PH, Nuti M. et al. A spectrum of monoclonal antibodies reactive with human mammary tumor cells. Proc Natl Acad Sci USA 1981; 78: 3199-3203
    CrossrefPubMedSearch in Google Scholar
  • 7 Wang SL, Yu GY, Yao J. et al. Diagnostic role of carbohydrate antigen 72-4 for gastrointestinal malignancy screening in Chinese patients: A prospective study. J Dig Dis 2018; 19: 685-692
    CrossrefPubMedSearch in Google Scholar
  • 8 Hu PJ, Chen MY, Wu MS. et al. Clinical evaluation of CA72-4 for screening gastric cancer in a healthy population: a multicenter retrospective study. Cancers (Basel) 2019; 11. DOI:10.3390/cancers11050733
    PubMed
  • 9 Mariampillai AI, Cruz JPD, Suh J. et al. Cancer antigen 72-4 for the monitoring of advanced tumors of the gastrointestinal tract, lung, breast and ovaries. Anticancer Res 2017; 37: 3649-3656
    CrossrefPubMedSearch in Google Scholar
  • 10 Bai X, Sun M, He Y. et al. Serum CA72-4 is specifically elevated in gout patients and predicts flares. Rheumatology (Oxford) 2020; 59: 2872-2880
    CrossrefPubMedSearch in Google Scholar
  • 11 Gross JL, de Azevedo MJ, Silveiro SP. et al. Diabetic nephropathy: Diagnosis, prevention, and treatment. Diabetes Care 2005; 28: 164-176
    CrossrefPubMedSearch in Google Scholar
  • 12 Gupta R, Misra A. Epidemiology of microvascular complications of diabetes in South Asians and comparison with other ethnicities. J Diabetes 2016; 8: 470-482
    CrossrefPubMedSearch in Google Scholar
  • 13 Molitch ME, DeFronzo RA, Franz MJ. et al. Diabetic nephropathy. Diabetes Care 2003; 26: S94-S98
    CrossrefPubMedSearch in Google Scholar
  • 14 Shang X, Song C, Du X. et al. The serum levels of tumor marker CA19-9, CEA, CA72-4, and NSE in type 2 diabetes without malignancy and the relations to the metabolic control. Saudi Med J 2017; 38: 204-208
    CrossrefPubMedSearch in Google Scholar
  • 15 Chen C, Zhao L, Ning Z. et al. Famine exposure in early life is associated with visceral adipose dysfunction in adult females. Eur J Nutr 2019; 58: 1625-1633
    CrossrefPubMedSearch in Google Scholar
  • 16 Chen C, Xu H, Chen Y. et al. Iodized salt intake and its association with urinary iodine, thyroid peroxidase antibodies, and thyroglobulin antibodies among urban Chinese. Thyroid 2017; 27: 1566-1573
    CrossrefPubMedSearch in Google Scholar
  • 17 Chen C, Zhai H, Cheng J. et al. Causal link between vitamin D and total testosterone in men: A Mendelian randomization analysis. J Clin Endocrinol Metab 2019; 104: 3148-3156
    CrossrefPubMedSearch in Google Scholar
  • 18 Lv X, Sun W, Huang X. et al. Association of serum fetuin-A levels with the risk of albuminuria in middle-aged and elderly Chinese. J Clin Endocrinol Metab 2016; 101: 1235-1242
    CrossrefPubMedSearch in Google Scholar
  • 19 Wu J, Li X, Tao Y. et al. Free triiodothyronine levels are associated with diabetic nephropathy in euthyroid patients with type 2 diabetes. Int J Endocrinol 2015; 2015: 204893
    CrossrefPubMedSearch in Google Scholar
  • 20 Demirci H, Erdamar H, Karakoc A. et al. CA 72-4 levels in patients with type 2 diabetes mellitus. Int J Clin Pract 2010; 64: 34-38
    CrossrefPubMedSearch in Google Scholar
  • 21 Liu D, Xu M, Ding LH. et al. Activation of the Nlrp3 inflammasome by mitochondrial reactive oxygen species: A novel mechanism of albumin-induced tubulointerstitial inflammation. Int J Biochem Cell Biol 2014; 57: 7-19
    CrossrefPubMedSearch in Google Scholar
  • 22 Zhuang Y, Yasinta M, Hu C. et al. Mitochondrial dysfunction confers albumin-induced NLRP3 inflammasome activation and renal tubular injury. Am J Physiol Renal Physiol 2015; 308: F857-F866
    CrossrefPubMedSearch in Google Scholar
  • 23 Jheng HF, Tsai PJ, Chuang YL. et al. Albumin stimulates renal tubular inflammation through an HSP70-TLR4 axis in mice with early diabetic nephropathy. Dis Model Mech 2015; 8: 1311-1321
    CrossrefPubMedSearch in Google Scholar
  • 24 Inker LA, Coresh J, Levey AS. et al. Estimated GFR, albuminuria, and complications of chronic kidney disease. J Am Soc Nephrol 2011; 22: 2322-2331
    CrossrefPubMedSearch in Google Scholar
  • 25 Klammt S, Wojak HJ, Mitzner A. et al. Albumin-binding capacity (ABiC) is reduced in patients with chronic kidney disease along with an accumulation of protein-bound uraemic toxins. Nephrol Dial Transplant 2012; 27: 2377-2383
    CrossrefPubMedSearch in Google Scholar
  • 26 Narita T, Sasaki H, Hosoba M. et al. Parallel increase in urinary excretion rates of immunoglobulin G, ceruloplasmin, transferrin, and orosomucoid in normoalbuminuric type 2 diabetic patients. Diabetes Care 2004; 27: 1176-1181
    CrossrefPubMedSearch in Google Scholar
  • 27 Gluhovschi C, Gluhovschi G, Petrica L. et al. Urinary biomarkers in the assessment of early diabetic nephropathy. J Diabetes Res 2016; 2016: 4626125
    CrossrefPubMedSearch in Google Scholar
  • 28 Chen C, Wang C, Hu C. et al. Normoalbuminuric diabetic kidney disease. Front Med 2017; 11: 310-318
    CrossrefPubMedSearch in Google Scholar
  • 29 Ali MK, Bullard KM, Saydah S. et al. Cardiovascular and renal burdens of prediabetes in the USA: Analysis of data from serial cross-sectional surveys, 1988-2014. Lancet Diabetes Endocrinol 2018; 6: 392-403
    CrossrefPubMedSearch in Google Scholar