title: Low serum amylase in association with metabolic syndrome and diabetes: A community-based study.
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.
  
  
  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.
authors.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
authors.forename: Kei
authors.initials: K
authors.lastname: Nakajima
authors.forename: Tohru
authors.initials: T
authors.lastname: Nemoto
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Muneyuki
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kakei
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fuchigami
authors.forename: Hiromi
authors.initials: H
authors.lastname: Munakata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood*; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000201:enzymology* / Q000453:epidemiology / Q000503:physiopathology; D015536:Down-Regulation; D005260:Female; D005919:Glomerular Filtration Rate; D005951:Glucose Tolerance Test; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007668:Kidney / Q000503:physiopathology; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000201:enzymology* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D016017:Odds Ratio; D010179:Pancreas / Q000201:enzymology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D000681:Amylases