Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
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Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2014, vol. 23, nr 6, November-December, p. 907–912

Publication type: original article

Language: English

The Role of Metabolic Syndrome and Related Clinical Variables in Determining CEA Levels

Alireza Esteghamati1,A,E,F, Ali Zandieh1,A,B,C,D, Afshin Saadipoor1,B,C, Nima Hafezi-Nejad1,B,C,D, Sina Noshad1,B,C,D, Abdoulreza Esteghamati1,2,E,F, Seyedomid Seyedahmadinejad1,B, Manouchehr Nakhjavani1,E,F

1 Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Pediatrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Abstract

Objectives. The aim of the study was to investigate how metabolic syndrome (MetS) and related clinical variables correlate with high levels of carcinoembryonic antigen (CEA).
Material and Methods. Variables related to MetS as well as the serum CEA levels of 366 subjects were assayed. Logistic regression analyses were used to determine the associations between various clinical variables and high CEA levels, which were defined as values greater than the median (i.e., 1.4 ng/mL).
Results. MetS, as an entity, and diabetes were more prevalent in subjects with high CEA levels (for MetS: 64.2% in subjects with CEA ≥ 1.4 vs. 51.1% in subjects with CEA < 1.4 ng/mL, p < 0.05; for diabetes: 72.6% vs. 59.1% respectively, p < 0.05). Waist circumference, triglycerides, fasting plasma glucose (FPG), homeostasis-model assessment of insulin resistance index (HOMA-IR), and HbA1c as well as systolic and diastolic blood pressures were directly associated with CEA levels, after adjusting for age and sex (p < 0.05). Subjects with a greater number of MetS components tended to have high CEA levels. Multivariate regression analysis revealed that the association of waist circumference and FPG with CEA is independent of other MetS components, age and sex.
Conclusion. MetS and related clinical variables contribute to CEA values. Thus, the reference interval of CEA may differ according to the clinical status of the subjects.

Key words

CEA, metabolic syndrome, obesity, insulin resistance.

References (43)

  1. Duffy MJ: Carcinoembryonic antigen as a marker for colorectal cancer: is it clinically useful? Clin Chem 2001, 47, 624–630.
  2. Dbouk HA, Tawil A, Nasr F, Kandakarjian L, Abou-Merhi R: Significance of CEA and VEGF as Diagnostic Markers of Colorectal Cancer in Lebanese Patients. Open Clin Cancer J 2007, 1, 1–5.
  3. Hammarstrom S: The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues. Semin Cancer Biol 1999, 9, 67–81.
  4. Mittal A, Farooqui SM, Pyrtuh S, Poudel B, Sathian B, Yadav SK: Efficacy of carcinogenic embryonic antigen in differential diagnosis of diseases of pancreas and liver – a comparative study in a tertiary care hospital of Western Nepal. Asian Pac J Cancer Prev 2012, 13, 275–277.
  5. Lye WC, Tambyah P, Leong SO, Lee EJ: Serum tumor markers in patients on dialysis and kidney transplantation. Adv Perit Dial 1994, 10, 109–111.
  6. Ruibal Morell A: CEA serum levels in non-neoplastic disease. Int J Biol Markers 1992, 7, 160–166.
  7. Witherspoon LR, Shuler SE, Alyea K, Husserl FE: Carcinoembryonic antigen: assay following heat compared with perchloric acid extraction in patients with colon cancer, non-neoplastic gastrointestinal diseases, or chronic renal failure. J Nucl Med 1983, 24, 916–921.
  8. Bulut I, Arbak P, Coskun A, Balbay O, Annakkaya AN, Yavuz O: Comparison of serum CA 19.9, CA 125 and CEA levels with severity of chronic obstructive pulmonary disease. Med Princ Pract 2009, 18, 289–293.
  9. Esteghamati A, Zandieh A, Khalilzadeh O, Meysamie A, Ashraf H: Clustering of metabolic syndrome components in a Middle Eastern diabetic and non-diabetic population. Diabetol Metab Syndr 2010, 2, 36.
  10. Cho LW: Metabolic syndrome. Singapore Med J 2011, 52, 779–785.
  11. Schwarz PE, Reimann M, Li J, Bergmann A, Licinio J, Wong ML: The Metabolic Syndrome – a global challenge for prevention. Horm Metab Res 2007, 39, 777–780.
  12. Esteghamati A, Zandieh A, Khalilzadeh O, Morteza A, Meysamie A, Nakhjavani M: Clustering of leptin and physical activity with components of metabolic syndrome in Iranian population: an exploratory factor analysis. Endocrine 2010, 38, 206–213.
  13. Meigs JB: Invited commentary: insulin resistance syndrome? Syndrome X? Multiple metabolic syndrome? A syndrome at all? Factor analysis reveals patterns in the fabric of correlated metabolic risk factors. Am J Epidemiol 2000, 152, 908–911, discussion 912.
  14. Pais R, Silaghi H, Silaghi AC, Rusu ML, Dumitrascu DL: Metabolic syndrome and risk of subsequent colorectal cancer. World J Gastroenterol 2009, 15, 5141–5148.
  15. Capasso I, Esposito E, Pentimalli F, Crispo A, Montella M, Grimaldi M: Metabolic syndrome affects breast cancer risk in postmenopausal women: National Cancer Institute of Naples experience. Cancer Biol Ther 2011, 10, 1240–1243.
  16. Rosato V, Tavani A, Bosetti C, Pelucchi C, Talamini R, Polesel J: Metabolic syndrome and pancreatic cancer risk: a case-control study in Italy and meta-analysis. Metabolism 2011, 60, 1372–1378.
  17. Ford ES, Li C, Zhao G: Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes 2010, 2, 180–193.
  18. Chen HF, Chen P, Su YH, Su HF, Li CY: Ageand sex-specific risks of colorectal cancers in diabetic patients. Tohoku J Exp Med 2012, 226, 259–265.
  19. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC: Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985, 28, 412–419.
  20. Saydah SH, Platz EA, Rifai N, Pollak MN, Brancati FL, Helzlsouer KJ: Association of markers of insulin and glucose control with subsequent colorectal cancer risk. Cancer Epidemiol Biomarkers Prev 2003, 12, 412–418.
  21. Liu CS, Hsu HS, Li CI, Jan CI, Li TC, Lin WY: Central obesity and atherogenic dyslipidemia in metabolic syndrome are associated with increased risk for colorectal adenoma in a Chinese population. BMC Gastroenterol 2010, 10, 51.
  22. Ahmed RL, Schmitz KH, Anderson KE, Rosamond WD, Folsom AR: The metabolic syndrome and risk of incident colorectal cancer. Cancer 2006, 107, 28–36.
  23. Yeh CY, Hsieh PS, Chiang JM, Lai CC, Chen JS, Wang JY: Preoperative carcinoembryonic antigen elevation in colorectal cancer. Hepatogastroenterology 2011, 58, 1171–1176.
  24. Samy N, Ragab HM, El Maksoud NA, Shaalan M: Prognostic significance of serum Her2/neu, BCL2, CA15-3 and CEA in breast cancer patients: a short follow-up. Cancer Biomark 2010, 6, 63–72.
  25. Inal A, Kos FT, Algin E, Yildiz R, Berk V, Tugba Unek I: Prognostic factors in patients with advanced pancreatic cancer treated with gemcitabine alone or gemcitabine plus cisplatin: retrospective analysis of a multicenter study. J BUON 2012, 17, 102–105.
  26. Kim KN, Joo NS, Je SY, Kim KM, Kim BT, Park SB: Carcinoembryonic antigen level can be overestimated in metabolic syndrome. J Korean Med Sci 2011, 26, 759–764.
  27. Lee JW, Park KD, Im JA, Hwang HJ, Kim SH: Serum carcinoembryonic antigen is associated with metabolic syndrome in female Korean non-smokers. Clin Chim Acta 2011, 412, 527–530.
  28. Ishizaka N, Ishizaka Y, Toda E, Koike K, Yamakado M, Nagai R: Are serum carcinoembryonic antigen levels associated with carotid atherosclerosis in Japanese men? Arterioscler Thromb Vasc Biol 2008, 28, 160–165.
  29. Vassalle C, Pratali L, Ndreu R, Battaglia D, Andreassi MG: Carcinoembryonic antigen concentrations in patients with acute coronary syndrome. Clin Chem Lab Med 2010, 48, 1339–1343.
  30. Schiel R, Beltschikow W, Steiner T, Stein G: Diabetes, insulin, and risk of cancer. Methods Find Exp Clin Pharmacol 2006, 28, 169–175.
  31. Rajala MW, Scherer PE: Minireview: The adipocyte – at the crossroads of energy homeostasis, inflammation, and atherosclerosis. Endocrinology 2003, 144, 3765–3773.
  32. Ceschi M, Gutzwiller F, Moch H, Eichholzer M, Probst-Hensch NM: Epidemiology and pathophysiology of obesity as cause of cancer. Swiss Med Wkly 2007, 137, 50–56.
  33. Kaaks R, Lukanova A, Kurzer MS: Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev 2002, 11, 1531–1543.
  34. Kaaks R, Lukanova A: Effects of weight control and physical activity in cancer prevention: role of endogenous hormone metabolism. Ann N Y Acad Sci 2002, 963, 268–281.
  35. Reed MJ, Purohit A: Aromatase regulation and breast cancer. Clin Endocrinol (Oxf) 2001, 54, 563–571.
  36. Iyengar P, Combs TP, Shah SJ, Gouon-Evans V, Pollard JW, Albanese C: Adipocyte-secreted factors synergistically promote mammary tumorigenesis through induction of anti-apoptotic transcriptional programs and protooncogene stabilization. Oncogene 2003, 22, 6408–6423.
  37. Balkwill F, Mantovani A: Inflammation and cancer: back to Virchow? Lancet 2001, 357, 539–545.
  38. Di Carlo E, Forni G, Lollini P, Colombo MP, Modesti A, Musiani P: The intriguing role of polymorphonuclear neutrophils in antitumor reactions. Blood 2001, 97, 339–345.
  39. Bjerner J, Hogetveit A, Wold Akselberg K, Vangsnes K, Paus E, Bjoro T: Reference intervals for carcinoembryonic antigen (CEA), CA125, MUC1, Alfa-foeto-protein (AFP), neuron-specific enolase (NSE) and CA19.9 from the NORIP study. Scand J Clin Lab Invest 2008, 68, 703–713.
  40. Woo HY, Kim YJ, Park H: Establishment of reference intervals of tumor markers in Korean adults. Korean J Lab Med 2008, 28, 179–184.
  41. Behbehani AI, Mathew A, Farghaly M, van Dalen A: Reference levels of the tumor markers carcinoembryonic antigen, the carbohydrate antigens 19-9 and 72-4, and cytokeratin fragment 19 using the Elecsys Relecsys 1010 analyzer in a normal population in Kuwait. The importance of the determination of local reference levels. Int J Biol Markers 2002, 17, 67–70.
  42. Qin X, Lin L, Mo Z, Lv H, Gao Y, Tan A: Reference intervals for serum alpha-fetoprotein and carcinoembryonic antigen in Chinese Han ethnic males from the Fangchenggang Area Male Health and Examination Survey. Int J Biol Markers 2011, 26, 65–71.
  43. Engaras B, Hafstrom L, Kewenter J, Nilsson O, Wedel H: Standard serum concentrations and normal fluctuations of CEA, CA 50 and CA 242 during twelve months in men and women aged 60–64 years without malignant disease. Eur J Surg 1999, 165, 110–116.
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