Jump to ContentJump to Main Navigation
Show Summary Details

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

12 Issues per year

IMPACT FACTOR increased in 2015: 3.017
Rank 5 out of 30 in category Medical Laboratory Technology in the 2014 Thomson Reuters Journal Citation Report/Science Edition

SCImago Journal Rank (SJR) 2015: 0.873
Source Normalized Impact per Paper (SNIP) 2015: 0.982
Impact per Publication (IPP) 2015: 2.238

See all formats and pricing
Volume 51, Issue 7 (Jul 2013)


Serum carcinoembryonic antigen is associated with non-alcoholic fatty liver disease in healthy Korean non-smokers

Jee-Yon Lee
  • Department of Family Medicine, Severance Hospital, Yonsei University, College of Medicine, Seodaemun-gu, Korea
/ Duk-Chul Lee
  • Department of Family Medicine, Severance Hospital, Yonsei University, College of Medicine, Seodaemun-gu, Korea
/ Ji-Won Lee
  • Corresponding author
  • Department of Family Medicine, Severance Hospital, Yonsei University, College of Medicine, Seodaemun-gu, Korea
  • Email:
Published Online: 2013-02-07 | DOI: https://doi.org/10.1515/cclm-2012-0585


Background: Carcinoembryonic antigen (CEA), a biomarker overexpressed in malignant tumors, exhibits increased levels in certain non-malignant conditions, including chronic inflammatory status. The elevation of CEA in chronic inflammatory conditions suggests that this marker may also be associated with non-alcoholic fatty liver disease (NAFLD). Therefore, we investigated the relationship between serum CEA concentrations and NAFLD in healthy Korean non-smokers.

Methods: A total of 200 healthy Korean non-smokers were enrolled during their routine health check-ups. Biomarkers of metabolic risk factors were assessed along with the presence of NAFLD using the liver Fibroscan®. Serum CEA levels were measured using a chemiluminescence immunoassay analyzer.

Results: The prevalence of NAFLD increased significantly with increasing CEA quartiles; the mean log CEA level increased gradually according to the grade of hepatic steatosis. Multivariate logistic regression analysis adjusted for age, gender, body mass index, exercise, blood pressure, fasting glucose, insulin, total cholesterol, triglycerides, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, white blood cell counts, aspartate aminotransferase, alanine aminotransferase and γ-glutamyltransferase showed that the fourth CEA quartile was associated with NAFLD, with an odds ratio of 2.98 (95% confidence interval 1.10–8.05, p<0.01).

Conclusions: Our study showed independent associations between CEA and NAFLD by analyzing data from 200 healthy Korean non-smokers, suggesting that CEA functions in the pathophysiology of fatty liver disease. Further studies are required to better understand the clinical and pathophysiological significance of our findings.

Keywords: carcinoembryonic antigen (CEA); inflammation; non-alcoholic fatty liver disease


  • 1.

    Hamaguchi M, Kojima T, Takeda N, Nakagawa T, Taniguchi H, Fujii K, et al. The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med 2005;143:722–8.

  • 2.

    Clark JM, Brancati FL, Diehl AM. Nonalcoholic fatty liver disease. Gastroenterology 2002;122:1649–57.

  • 3.

    Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology 1999;116:1413–9.

  • 4.

    Rector RS, Thyfault JP, Wei Y, Ibdah JA. Non-alcoholic fatty liver disease and the metabolic syndrome: an update. World J Gastroenterol 2008;14:185. [Crossref] [PubMed]

  • 5.

    Choudhury J, Sanyal AJ. Insulin resistance and the pathogenesis of nonalcoholic fatty liver disease. Clin Liver Dis 2004; 8:575. [PubMed] [Crossref]

  • 6.

    Targher G, Day CP, Bonora E. Risk of cardiovascular disease in patients with nonalcoholic fatty liver disease. N Engl J Med 2010;363:1341–50. [Web of Science]

  • 7.

    Wieckowska A, Papouchado BG, Li ZZ, Lopez R, Zein NN, Feldstein AE. Increased hepatic and circulating interleukin-6 levels in human nonalcoholic steatohepatitis. Am J Gastroenterol 2008;103:1372–9.

  • 8.

    Leclercq IA, Field J, Farrell GC. Leptin-specific mechanisms for impaired liver regeneration ob/ob mice after toxic injury. Gastroenterology 2003;124:1451–64.

  • 9.

    Gold P, Freedman SO. Demonstration of tumor-specific antigens in human colonic carcinomata by immunological tolerance and absorption techniques. J Exp Med 1965;121:439–62.

  • 10.

    Hammarström S. The carcinoembryonic antigen (CEA) family: structures, suggested functions and expression in normal and malignant tissues. Semin Cancer Biol 1999;9:67–81. [Crossref] [PubMed]

  • 11.

    Ruibal MA. CEA serum levels in non-neoplastic disease. Int J Biol Markers 1992;7:160.

  • 12.

    Ishizaka N, Ishizaka Y, Toda EI, Koike K, Yamakado M, Nagai R. Are serum carcinoembryonic antigen levels associated with carotid atherosclerosis in Japanese men? Arterioscler Thromb Vasc Biol 2008;28:160–5. [PubMed] [Web of Science]

  • 13.

    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: 527–30.

  • 14.

    Ganguly A, Yeltsin E, Robbins J. Identification of a carcinoembryonic antigen binding protein on monocytes. Biochem Biophys Res Commun 2003;311:319–23.

  • 15.

    Aarons CB, Bajenova O, Andrews C, Heydrick S, Bushell KN, Reed KL, et al. Carcinoembryonic antigen-stimulated THP-1 macrophages activate endothelial cells and increase cell–cell adhesion of colorectal cancer cells. Clin Exp Metastasis 2007;24:201–9. [Web of Science] [Crossref]

  • 16.

    Compton C, Fenoglio‐Preiser CM, Pettigrew N, Fielding LP. American Joint Committee on Cancer prognostic factors consensus conference. Cancer 2000;88:1739–57.

  • 17.

    Sasso M, Beaugrand M, De Ledinghen V, Douvin C, Marcellin P, Poupon R, et al. Controlled attenuation parameter (CAP): a novel VCTE™ guided ultrasonic attenuation measurement for the evaluation of hepatic steatosis: preliminary study and validation in a cohort of patients with chronic liver disease from various causes. Ultrasound Med Biol 2010;36:1825–35. [Crossref] [Web of Science]

  • 18.

    Prati D, Taioli E, Zanella A, Della Torre E, Butelli S, Del Vecchio E, et al. Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann Intern Med 2002;137:1–10.

  • 19.

    Clark JM, Diehl AM. Defining nonalcoholic fatty liver disease: implications for epidemiologic studies. Gastroenterology 2003;124:248–50.

  • 20.

    Jessup J, Giavazzi R, Campbell D, Cleary K, Morikawa K, Fidler I. Growth potential of human colorectal carcinomas in nude mice: association with the preoperative serum concentration of carcinoembryonic antigen in patients. Cancer Res 1988;48:1689. [PubMed]

  • 21.

    Loewenstein M, Zamcheck N. Carcinoembryonic antigen (CEA) levels in benign gastrointestinal disease states. Cancer 1978;42:1412–8.

  • 22.

    Park SH, Kim BI, Yun JW, Kim JW, Park DI, Cho YK, et al. Insulin resistance and C‐reactive protein as independent risk factors for non‐alcoholic fatty liver disease in non‐obese Asian men. J Gastroenterol Hepatol 2004;19:694–8. [PubMed] [Crossref]

  • 23.

    Lee JY, Lee HK, Lee DC, Lee JW. Serum carcinoembryonic antigen is associated with abdominal visceral fat accumulation in female Korean nonsmokers. PLoS One 2012;7:e43518. [Web of Science] [PubMed]

  • 24.

    Castera L, Forns X, Alberti A. Non-invasive evaluation of liver fibrosis using transient elastography. J Hepatol 2008;48: 835–47. [Crossref] [PubMed]

  • 25.

    Lédinghen V, Vergniol J, Foucher J, Merrouche W, Bail B. Non‐invasive diagnosis of liver steatosis using controlled attenuation parameter (CAP) and transient elastography. Liver Int 2012;32:911–8. [PubMed] [Web of Science] [Crossref]

  • 26.

    Charatcharoenwitthaya P, Lindor KD. Role of radiologic modalities in the management of non-alcoholic steatohepatitis. Clin Liver Dis 2007;11:37–54. [PubMed] [Crossref]

About the article

Corresponding author: Ji-Won Lee, MD, Department of Family Medicine, Severance Hospital, Yonsei University, College of Medicine, 250 Seongsanno, Seodaemun-gu, 120–752, Korea, Phone: +82 2 22282338, Fax: +82 2 3622473

Received: 2012-09-07

Accepted: 2013-01-03

Published Online: 2013-02-07

Published in Print: 2013-07-01

Citation Information: Clinical Chemistry and Laboratory Medicine, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2012-0585. Export Citation

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Rahim Ahmadi and Sedigheh Molaei
Zahedan Journal of Research in Medical Sciences, 2015, Volume 17, Number 3
Rahim Ahmadi and Sedigheh Molaei
Zahedan Journal of Research in Medical Sciences, 2015, Volume 17, Number 3

Comments (0)

Please log in or register to comment.
Log in