Abstract:
Introduction: Obesity has been recently shown to affect serum tumor markers, potentially influencing the sensitivity of screening programs and interpretation of results. Expansion of plasma volume and chronic inflammation may drive these differences, which may affect markers disparately. The present study aims to determine the effect of BMI on common tumor markers and if a BMI-specific reference range is needed in an Indian cohort.
Methods: This was a cross-sectional study conducted at a tertiary care center in Eastern India. The study group consisted of 117 subjects, 59 obese and 58 normal weight controls. Serum tumor markers were analyzed via Chemiluminescence Immunoassay(CLIA). Mann–Whitney U tests were performed for between-group differences as well as quantile regression for interaction effects across the distribution. ROC curves were used to visualize areas of greatest effect by obesity status.
Results: Obese status affected each tumor marker differently. Carcinoembryonic Antigen (CEA) and CA 19-9 had decreased mean values in obese patients compared to normal weight controls, supporting hemodilution effect as hypothesized.Furthermore, there was a significant interaction between female sex and obesity status for CEA (p=0.029), indicating lower values in obese women compared to both obese males and normal weight females. Markers with presumed stronger associations with inflammatory/metabolic processes demonstrated higher values among obese patients. PSA levels were higher in obese males, while CA125 mean values and variability were higher in obese females.
Conclusion: Serum tumor markers are affected disparately by obesity in our cohort. Decreased values of CEA and CA 19-9 may lead to false-negative interpretations, while increased PSA and CA 125 in obese males and females respectively may lead to false positives. This supports the creation of BMI specific reference intervals for tumor markers.
Biography:
Dr. Sahitya Kr. Jasu is a MBBS Intern at Calcutta National Medical College & Hospital(CNMCH), WBUHS. He holds a MBBS Degree from CNMCH,WBUHS. He has been involved in undergraduate research since 2nd year of MBBS
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