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Low serum amylase in association with metabolic syndrome and diabetes: A community-based study.

Nakajima K, Nemoto T, Muneyuki T, Kakei M, Fuchigami H, Munakata H - Cardiovasc Diabetol (2011)

Bottom Line: However, few clinical studies have addressed this issue.Multiple logistic analyses showed that, compared with highest quartile of serum amylase, lowest quartile was associated with increased risk for MetS and diabetes after adjustment for confounding factors [odds ratio (95% CI), 2.07 (1.39-3.07) and 2.76 (1.49-5.11), respectively].These results suggest a pancreatic exocrine-endocrine relationship in certain clinical conditions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Clinical Nutrition, Department of Medical Dietetics, Faculty of Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan. keinaka@josai.ac.jp

ABSTRACT

Background: Low serum amylase levels may reflect impaired exocrine-endocrine relationship in the pancreas. However, few clinical studies have addressed this issue. Therefore, in this epidemiological study, we investigated whether low serum amylase was associated with the pathogenesis of impaired insulin action: metabolic syndrome (MetS) and diabetes.

Research design and methods: Serum amylase, cardiometabolic risk factors, MetS (Adult Treatment Panel III criteria), and diabetes were examined in 2,425 asymptomatic subjects aged 30-80 years who underwent medical checkups recently (April 2009-March 2010) and 5 years ago.

Results: Clinical variables, except for age and estimated glomerular filtration rate (eGFR), shifted favorably with increasing serum amylase levels. Plasma glucose levels at 1- and 2-hr during OGTT increased significantly with decreasing serum amylase levels. Multiple logistic analyses showed that, compared with highest quartile of serum amylase, lowest quartile was associated with increased risk for MetS and diabetes after adjustment for confounding factors [odds ratio (95% CI), 2.07 (1.39-3.07) and 2.76 (1.49-5.11), respectively]. In subjects who underwent checkups 5 years ago (n = 571), lower amylase at the previous checkup were associated with larger numbers of metabolic abnormalities at the recent checkup. The fluctuation over time in serum amylase levels in subjects with low serum amylase at the previous checkup was slight and was unaffected by kidney dysfunction.

Conclusions: Our results indicate that low serum amylase is associated with increased risk of metabolic abnormalities, MetS and diabetes. These results suggest a pancreatic exocrine-endocrine relationship in certain clinical conditions.

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Related in: MedlinePlus

Serum amylase levels according to the number of ATP-III-MetS components (NAMC). The numbers of nonsmokers with NAMCs of 0, 1, 2 and 3-5 are 472, 580, 438 and 306, respectively. The numbers of smokers with NAMCs of 0, 1, 2 and 3-5 are 169, 184, 144 and 132, respectively. The serum amylase level decreased significantly with increasing NAMC in both nonsmokers and smokers (both P < 0.0001, ANOVA), and was significantly different between nonsmokers and smokers (P < 0.0001, ANOVA). White triangles = nonsmokers, black triangles = smokers. Values are means ± SE.
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Figure 1: Serum amylase levels according to the number of ATP-III-MetS components (NAMC). The numbers of nonsmokers with NAMCs of 0, 1, 2 and 3-5 are 472, 580, 438 and 306, respectively. The numbers of smokers with NAMCs of 0, 1, 2 and 3-5 are 169, 184, 144 and 132, respectively. The serum amylase level decreased significantly with increasing NAMC in both nonsmokers and smokers (both P < 0.0001, ANOVA), and was significantly different between nonsmokers and smokers (P < 0.0001, ANOVA). White triangles = nonsmokers, black triangles = smokers. Values are means ± SE.

Mentions: The clinical characteristics of subjects according to serum amylase quartile are shown in Table 1. Across increasing amylase quartiles, the prevalence of men, smokers, daily alcohol consumption, infrequent exercise, MetS, and diabetes decreased significantly. Most clinical variables were decreased (HDL-C was increased) across increasing amylase quartiles, except for age and eGFR which showed unfavorable changes. Intriguingly, the prevalence of history of stroke and medications for hypercholesterolemia were higher in the highest quartile. Unexpectedly, the statistical significance for the relationship between HbA1c and serum amylase was weaker (P = 0.02) than that of other variables. Of clinical parameters listed in Table 1, stepwise regression analysis revealed that serum amylase level was significantly explained by BMI, eGFR, smoking, age, daily alcohol consumption, FPG, diastolic blood pressure, and triglyceride (ß coefficient = -0.17, -0.17, -0.11, 0.11, -0.07, -0.05, -0.05, and -0.04, respectively, data not shown). Figure 1 shows serum amylase levels according to NAMC categories. In both non-smokers and in smokers, serum amylase levels decreased significantly with increasing NAMC almost in parallel, with an approximately 10 IU/l decline in smokers. Figure 2 shows the changes in plasma glucose levels during OGTTs according to serum amylase quartiles. Because subjects with definite diabetes did not undergo OGTT, overall responses to OGTT showed a near-normal pattern. Nevertheless, the plasma glucose levels at 1- and 2-hrs increased significantly with decreasing amylase quartiles.


Low serum amylase in association with metabolic syndrome and diabetes: A community-based study.

Nakajima K, Nemoto T, Muneyuki T, Kakei M, Fuchigami H, Munakata H - Cardiovasc Diabetol (2011)

Serum amylase levels according to the number of ATP-III-MetS components (NAMC). The numbers of nonsmokers with NAMCs of 0, 1, 2 and 3-5 are 472, 580, 438 and 306, respectively. The numbers of smokers with NAMCs of 0, 1, 2 and 3-5 are 169, 184, 144 and 132, respectively. The serum amylase level decreased significantly with increasing NAMC in both nonsmokers and smokers (both P < 0.0001, ANOVA), and was significantly different between nonsmokers and smokers (P < 0.0001, ANOVA). White triangles = nonsmokers, black triangles = smokers. Values are means ± SE.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3102610&req=5

Figure 1: Serum amylase levels according to the number of ATP-III-MetS components (NAMC). The numbers of nonsmokers with NAMCs of 0, 1, 2 and 3-5 are 472, 580, 438 and 306, respectively. The numbers of smokers with NAMCs of 0, 1, 2 and 3-5 are 169, 184, 144 and 132, respectively. The serum amylase level decreased significantly with increasing NAMC in both nonsmokers and smokers (both P < 0.0001, ANOVA), and was significantly different between nonsmokers and smokers (P < 0.0001, ANOVA). White triangles = nonsmokers, black triangles = smokers. Values are means ± SE.
Mentions: The clinical characteristics of subjects according to serum amylase quartile are shown in Table 1. Across increasing amylase quartiles, the prevalence of men, smokers, daily alcohol consumption, infrequent exercise, MetS, and diabetes decreased significantly. Most clinical variables were decreased (HDL-C was increased) across increasing amylase quartiles, except for age and eGFR which showed unfavorable changes. Intriguingly, the prevalence of history of stroke and medications for hypercholesterolemia were higher in the highest quartile. Unexpectedly, the statistical significance for the relationship between HbA1c and serum amylase was weaker (P = 0.02) than that of other variables. Of clinical parameters listed in Table 1, stepwise regression analysis revealed that serum amylase level was significantly explained by BMI, eGFR, smoking, age, daily alcohol consumption, FPG, diastolic blood pressure, and triglyceride (ß coefficient = -0.17, -0.17, -0.11, 0.11, -0.07, -0.05, -0.05, and -0.04, respectively, data not shown). Figure 1 shows serum amylase levels according to NAMC categories. In both non-smokers and in smokers, serum amylase levels decreased significantly with increasing NAMC almost in parallel, with an approximately 10 IU/l decline in smokers. Figure 2 shows the changes in plasma glucose levels during OGTTs according to serum amylase quartiles. Because subjects with definite diabetes did not undergo OGTT, overall responses to OGTT showed a near-normal pattern. Nevertheless, the plasma glucose levels at 1- and 2-hrs increased significantly with decreasing amylase quartiles.

Bottom Line: However, few clinical studies have addressed this issue.Multiple logistic analyses showed that, compared with highest quartile of serum amylase, lowest quartile was associated with increased risk for MetS and diabetes after adjustment for confounding factors [odds ratio (95% CI), 2.07 (1.39-3.07) and 2.76 (1.49-5.11), respectively].These results suggest a pancreatic exocrine-endocrine relationship in certain clinical conditions.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Clinical Nutrition, Department of Medical Dietetics, Faculty of Pharmaceutical Sciences, Josai University, 1-1 Keyakidai, Sakado, Saitama, 350-0295, Japan. keinaka@josai.ac.jp

ABSTRACT

Background: Low serum amylase levels may reflect impaired exocrine-endocrine relationship in the pancreas. However, few clinical studies have addressed this issue. Therefore, in this epidemiological study, we investigated whether low serum amylase was associated with the pathogenesis of impaired insulin action: metabolic syndrome (MetS) and diabetes.

Research design and methods: Serum amylase, cardiometabolic risk factors, MetS (Adult Treatment Panel III criteria), and diabetes were examined in 2,425 asymptomatic subjects aged 30-80 years who underwent medical checkups recently (April 2009-March 2010) and 5 years ago.

Results: Clinical variables, except for age and estimated glomerular filtration rate (eGFR), shifted favorably with increasing serum amylase levels. Plasma glucose levels at 1- and 2-hr during OGTT increased significantly with decreasing serum amylase levels. Multiple logistic analyses showed that, compared with highest quartile of serum amylase, lowest quartile was associated with increased risk for MetS and diabetes after adjustment for confounding factors [odds ratio (95% CI), 2.07 (1.39-3.07) and 2.76 (1.49-5.11), respectively]. In subjects who underwent checkups 5 years ago (n = 571), lower amylase at the previous checkup were associated with larger numbers of metabolic abnormalities at the recent checkup. The fluctuation over time in serum amylase levels in subjects with low serum amylase at the previous checkup was slight and was unaffected by kidney dysfunction.

Conclusions: Our results indicate that low serum amylase is associated with increased risk of metabolic abnormalities, MetS and diabetes. These results suggest a pancreatic exocrine-endocrine relationship in certain clinical conditions.

Show MeSH
Related in: MedlinePlus