The Influence of Metformin on Serum Carbohydrate Antigen 19-9 (CA 19-9) Levels in Type 2 Diabetes Mellitus Patients.

Objectives: Diabetes mellitus has been claimed to be a risk factor for the development of pancreatic carcinoma. CA 19-9 has a great sensitivity in detection of pancreatic adenocarcinoma. Metformin exhibits a strong and consistent antiproliferative action on several cancer cell lines including pancreatic cancer. We aim to determine the influence of metformin on CA 19-9 levels in type 2 diabetes mellitus patients.

Methods: Total 193 patients with type 2 diabetes mellitus were registered for a single centre, cross-sectional study. On the basis of treatment modalities, patients were divided into metformin group (93 patients) and non-metformin group (100 patients). Detailed history, clinical examination, anthropometric measurements, serum CA 19-9 level, glucose and lipid metabolic profiles were determined. Results were presented as mean±SD. Association between CA 19-9 level and other variables were assessed with Pearson correlation and multiple stepwise regression analysis.

Results: Mean CA 19-9 level was 18.99±4.30 U/ml in the metformin group as compared to 30.49±5.61 U/ml in non-metformin group (p<0.001). Mean value of CA 19-9 was found highest among all i.e. 37.05±4.94 U/ml in patients taking insulin. Patients having lifestyle modification for the management of diabetes had their mean CA 19-9 level of 21.39±5.62 U/ml. CA 19-9 level is positively correlated with age, duration of diabetes, BMI, 2-hour Plasma Glucose level, HbA1C, VLDL cholesterol, triglyceride, total cholesterol, LDL cholesterol (p<0.005) and negatively correlated with HDL cholesterol (p<0.001).

Conclusion: Metformin is associated with lower level of CA 19-9 in type 2 diabetes mellitus patients. It may have a protective role in preventing pancreatic damage and pancreatic cancer in diabetic individuals. CA 19-9 level could be an effective indicator of glycemic control, disease progression and lipid metabolism in patients with type 2 diabetes mellitus.