CA 72-4 levels in patients with type 2 diabetes mellitus

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

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.

Serum CA72-4 is specifically elevated in gout patients and predicts flares

Objectives

Serum CA72-4 levels are elevated in some gout patients but this has not been comprehensively described. The present study profiled serum CA72-4 expression in gout patients and verified the hypothesis that CA72-4 is a predictor of future flares in a prospective gout cohort.

Methods

To profile CA72-4 expression, a cross-sectional study was conducted in subjects with gouty arthritis, asymptomatic hyperuricaemia, four major arthritis types (OA, RA, SpA, septic arthritis) and healthy controls. A prospective gout cohort study was initiated to test the value of CA72-4 for predicting gout flares. During a 6-month follow-up, gout flares, CA72-4 levels and other gout-related clinical variables were observed at 1, 3 and 6 months.

Results

CA72-4 was highly expressed in patients with gouty arthritis [median (interquartile range) 4.55 (1.56, 32.64) U/ml] compared with hyperuricaemia patients [1.47 (0.87, 3.29) U/ml], healthy subjects [1.59 (0.99, 3.39) U/ml] and other arthritis patients [septic arthritis, 1.38 (0.99, 2.66) U/ml; RA, 1.58 (0.95, 3.37) U/ml; SpA, 1.56 (0.98, 2.85) U/ml; OA, 1.54 (0.94, 3.34) U/ml; P < 0.001, respectively]. Gout patients with frequent flares (twice or more in the last year) had higher CA72-4 levels than patients with fewer flares (fewer than twice in the last year). High CA72-4 level (>6.9 U/ml) was the strongest predictor of gout flares (hazard ratio = 3.889). Prophylactic colchicine was effective, especially for patients with high CA72-4 levels (P = 0.014).

Conclusion

CA72-4 levels were upregulated in gout patients who experienced frequent flares and CA72-4 was a useful biomarker to predict future flares.

Increased serum CA724 levels in patients suffering gout vs cancers

CA724 is a clinically used serum biomarker used for cancer diagnosis, which includes digestive tract cancers (esophageal, gastric, and colorectal carcinomas), ovarian cancer, and nonsmall cell lung cancer. In general, the serum CA724 level is lower than 6U/mL in healthy controls and significantly higher in cancer patients. It has been further established that serum CA724 level is related to the pathological stage and prognosis of cancers. However, CA724 is not only expressed in tumor tissues but also in normal tissues such as the secretory endometrium and transitional colonic mucosa, which indicates that CA724 is not a unique product of cancer cells. Currently, the serum CA724 levels in patients suffering cancer or nonneoplasm diseases have not been systematically measured and compared. In our study, a total of 38,526 clinical lab test results of serum CA724 levels from healthy controls and patients suffering 34 different types of diseases including cancers and nonneoplasm illnesses during the past 3 years (2015-2018) were collected and analyzed. We found that the mean values of serum CA724 levels were significantly higher in patients suffering gout (23.7U/mL) and gouty arthritis (31.45U/mL) than that of cancer patients (Mann-Whitney test, p<0.0001). The summarized mean and median values of serum CA724 data for healthy controls vs patients suffering 34 different types of diseases indicated that the abnormal serum CA724 levels might be a systemic malfunction indicator rather than a cancer cell-secreted product; the log₁₀p values showed that CA724 is not only a cancer biomarker but also a potential biomarker for patients suffering gout.