Serum CA 19-9 and risk of incident diabetes in middle-aged and elderly Chinese: a prospective cohort study

Carbohydrate antigen (CA) 19-9 is a tumor marker for gastrointestinal and pancreatic cancers. Previous studies found that CA 19-9 was elevated in patients with diabetes, but little is known about its relationship with diabetes risk in prospective studies. Our objective was to evaluate the association between serum CA 19-9 and the risk of incident diabetes in Chinese population.

Data were obtained from a prospective cohort study among 2391 middle-aged and elderly Chinese with a median follow-up of 3.8 years. The measurement for the study outcome was incident diabetes.

Compared with individuals in the lowest quartile, those in the highest quartile of CA 19-9 had significantly higher incidence of diabetes (12.54 vs. 8.86%, P = 0.04). In the fully adjusted logistic regression model, compared with the lowest quartile, the highest quartile of CA 19-9 was significantly associated with 58% increased risk of incident diabetes [odds ratio (OR), 95% confidence interval (CI) 1.58, 1.02–2.44]. Stratified analysis suggested that the increased risk was seen only in women (OR, 95% CI 1.96, 1.10–3.48), or participants aged ≥65 (OR, 95% CI 2.32, 1.03–5.19), or those with body mass index ≥24 (OR, 95% CI 2.09, 1.20–3.63), or current nondrinkers (OR, 95% CI 1.79, 1.09–2.92), or those with impaired glucose regulation (IGR) (OR, 95% CI 2.49, 1.33–4.67). Significant interaction was detected between IGR and serum CA 19-9 (P for interaction <0.0001).

Serum CA 19-9 is associated with a significantly increased risk of diabetes among the middle-aged and elderly Chinese population. Further investigations are needed to confirm this association and disclose potential mechanisms.