Association of serum carbohydrate antigen 19-9 level with arterial stiffness and coronary artery calcification in middle-aged and older adults: A cross-sectional study

Objectives:Emerging evidence suggests that serum carbohydrate antigen 19-9 level is elevated in type 2 diabetes and metabolic syndrome, which are closely related with atherosclerotic cardiovascular disease. This study aimed to determine whether serum carbohydrate antigen 19-9 level is related to atherosclerosis as measured by brachial-ankle pulse wave velocity (PWV) and coronary calcium score (CCS).Methods:This cross-sectional study comprised 1732 Korean adults aged at least 45 years who underwent a health examination program. Serum carbohydrate antigen 19-9 level was quantified by chemiluminescence immunoassay and categorized as quartiles, after exclusion of participants with carbohydrate antigen 19-9 levels more than 30 U/ml to rule out hidden malignancy: Q1: 4.5 or less, Q2: 4.6-7.5, Q2: 7.6-12.2, and Q4: at least 12.3 ng/ml. High brachial-ankle PWV was defined as a level greater than 1570 cm/s (>75th percentile), and high CCS was defined as a level over 100. The odds ratios and 95% confidence intervals for high PWV and high CCS were calculated across serum carbohydrate antigen 19-9 quartiles using multiple logistic regression analysis.Results:The prevalence of high PWV and high CCS increased with serum carbohydrate antigen 19-9 quartile. Compared with the lowest quartile, the odds ratios (95% confidence intervals) of the highest carbohydrate antigen 19-9 quartile for high PWV and high CCS were 1.61 (1.05-2.48) and 2.03 (1.17-3.54), respectively, after adjusting for age, sex, BMI, smoking status, alcohol consumption, regular exercise, fasting plasma glucose, total cholesterol, hypertension, type 2 diabetes, and dyslipidemia.Conclusion:We found that serum carbohydrate antigen 19-9 level was positively and independently associated with arterial stiffness and coronary artery calcification.