Serum Amylase Levels in Relation to Islet β Cell Function in Patients with Early Type 2 Diabetes

Abstract

ObjectiveThe insulin-pancreatic acinar axis may play a major role in pancreatic function. Amylase is an exocrine enzyme that is produced by pancreatic acinar cells, and low serum amylase levels may be associated with endocrine diseases, such as metabolic syndrome and diabetes. We hypothesized that low serum amylase levels may be associated with impaired islet β cell function in type 2 diabetes. Therefore, we investigated the relationship between the serum amylase levels and islet β cell function in patients with early type 2 diabetes.MethodsThe cross-sectional study recruited 2327 patients with a mean of 1.71±1.62 years since their diagnosis of type 2 diabetes, and all participants were treated with lifestyle intervention alone. Serum amylase levels, the 75-g oral glucose tolerance test (OGTT) and metabolic risk factors were examined in all participants. The insulin sensitivity index (Matsuda index, ISIMatsuda) and insulin secretion index (ratio of total area-under-the-insulin-curve to glucose-curve, AUCins/glu) were derived from the OGTT. Integrated islet β cell function was assessed by the Insulin Secretion-Sensitivity Index-2 (ISSI-2) (ISIMatsuda multiplied by AUCins/glu).ResultsSerum amylase levels in the normal range were significantly correlated with ISIMatsuda, AUCins/glu and ISSI-2 (r = 0.203, 0.246 and 0.413, respectively, p<0.001). The association of the serum amylase levels with ISSI-2 (adjusted r = 0.363, p<0.001) was closer than the association with ISIMatsuda (adjusted r = 0.191, p<0.001) and AUCins/glu (adjusted r = 0.174, p<0.001) after adjusting for the anthropometric indices, time since the diagnosis of diabetes, lipid profiles, uric acid levels, estimated glomerular filtration rate, HbA1c levels, smoking and drinking using the partial correlation test. After adjusting for these metabolic risk factors in the multivariate regression analysis with the amylase levels as the dependent variable, ISSI-2 was the major independent contributor to the serum amylase levels (β = 0.416, t = 21.72, p<0.001). Meanwhile, in a comparison of the groups with the highest and lowest quartiles of serum amylase levels, the mean difference in logISSI-2 was 0.902 (95% CI 0.823 to 0.982), and after adjusting for metabolic risk factors, the mean difference in logISSI-2 was 0.610 (0.537 to 0.683).ConclusionsSerum amylase levels in the normal range are positively associated with integrated islet β cell function in patients with early type 2 diabetes, as assessed by ISSI-2.

Human amylase gene copy number variation as a determinant of metabolic state

“…Interestingly, serum amylase levels in obese participants increase following weight-loss. Further studies have replicated inverse correlations between serum amylase levels and BMI [60, 81,[84][85][86][87][88][89], impaired glucose tolerance [84], insulin resistance [60, 87,89], DM [88], waist circumference and percentage body fat [60,86], and a positive correlation of serum amylase levels with highdensity lipoprotein (HDL) cholesterol [84]. Although most of these studies were on Asian populations, others (that have also included assessment of salivary and pancreatic origins for serum amylase levels) have shown comparable results in European populations for each amylase origin [10,60].…”

“…It is known that insulin, delivered via a vascular portal route from the pancreatic islet cells directly to the acini [90], regulates pancreatic acinar function and actually stimulates secretion of pancreatic amylase and other exocrine products [14,90,91]. Low serum amylase levels may therefore result from impaired insulin secretion [14,81,89] or insulin resistance [89,92], as occurs in both obesity and type 2 DM [14,89,92]. Insulin may also influence release of salivary amylase [14,93,94], although this mechanism remains incompletely understood [14].…”

Starch Digestion–Related Amylase Genetic Variant Affects 2-Year Changes in Adiposity in Response to Weight-Loss Diets: The POUNDS Lost Trial

“…In epidemiological studies, low serum concentrations of amylase have been associated with elevated BMI (16–19), waist circumference (WC) (16,20), or visceral adipose tissue area (21). Furthermore, studies have suggested that AMY1 copy number also plays a role in glucose uptake and glucose metabolism (11,22).…”

Serum amylase activity altered by the ABO blood group system in Chinese subjects

“…It is reported that serum amylase activity is related with gestational diabetes mellitus . Moreover, serum amylase activity is linked to the islet β cell function in type 2 diabetes patients . In fact, serum amylase has been regarded as a biochemical marker to assess pancreatic exocrine function in patients with diabetes mellitus …”

“…2 Moreover, serum amylase activity is linked to the islet β cell function in type 2 diabetes patients. 3 In fact, serum amylase has been regarded as a biochemical marker to assess pancreatic exocrine function in patients with diabetes mellitus. 4 The ABO blood type antigens (A, B, and H determinants) are glycoproteins presenting human blood types and are widely distributed on red blood cell surface and normal tissue throughout the body.…”