Association of serum levels of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) with diabetes mellitus (DM): a systematic review and meta-analysis

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Background: Type 2 diabetes mellitus (T2DM) affects 537 million people worldwide, with its prevalence and complications continuing to rise despite advancements in treatment. Identifying novel biomarkers associated with glycemic control and diabetic complications remains crucial for improving disease management. Objective: We aimed to assess and quantify the association between serum levels of CA19-9 and CEA with T2DM and glycated hemoglobin (HbA1c) levels. Methods: A literature search was conducted using various databases and twelve eligible studies that reported serum levels of CA19-9 or/and CEA in T2DM patients and non-diabetic adult group were included. The pooled analysis was conducted using the random-effects model in Review Manager 5.4.1. To explore the cause of heterogeneity, sub-group analysis and meta-regression was performed. Results: = 96%] in T2DM patients as compared to the control group. Furthermore, uncontrolled diabetes (HbA1C > 7%) had greater levels of CA19-9 and CEA. Sub-group analysis demonstrated significant difference in the MD of CA 19-9 levels based on ethnicity and mean age of the individuals and HbA1c levels and MD of CEA levels significantly differed between the individuals with duration of diabetes > 10 years and < 10 years. Random-effects regression showed significant association between CA19-9 levels and BMI. Conclusion: This study highlights significant association between diabetes and elevated tumor markers. The association of CA 19-9 with BMI underscores the potential role of metabolic dysregulation. Supplementary Information: The online version contains supplementary material available at 10.1007/s13340-025-00863-5.

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