ELEVATED AMYLASE AND LIPASE LEVELS IN PATIENTS USING GLUCAGONLIKE PEPTIDE-1 RECEPTOR AGONISTS OR DIPEPTIDYL-PEPTIDASE-4 INHIBITORS IN THE OUTPATIENT SETTING
ELEVATED AMYLASE AND LIPASE LEVELS IN PATIENTS USING GLUCAGONLIKE PEPTIDE-1 RECEPTOR AGONISTS OR DIPEPTIDYL-PEPTIDASE-4 INHIBITORS IN THE OUTPATIENT SETTING
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DOI：
10.4158/ep11290.or
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发表时间：
2012-07-01
影响因子：
4.2
通讯作者：
Dua, Anuradha P.
中科院分区：
文献类型：
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作者：
Lando, Howard M.;Alattar, May;Dua, Anuradha P.
目的：探讨胰高血糖素样肽酶-1 （GLP-1）受体激动剂和二肽基肽酶-4 （DPP-4）抑制剂对2型糖尿病患者血清淀粉酶和脂肪酶水平的影响。方法：在90例2型糖尿病患者中，采用4种GLP-1激动剂或DPP-4抑制剂进行治疗。对照组由33名2型糖尿病患者组成，他们具有相似的特征，但没有使用这些药物。所有患者均测量基线血清淀粉酶和脂肪酶水平，并定期重复。我们确定了百分比。两组患者血清淀粉酶或脂肪酶水平升高（或两者均升高）。结果：在接受GLP-1受体激动剂或DPP-4抑制剂治疗的所有90例患者中，32例（36%）患者血清淀粉酶或脂肪酶（或两者都有）升高，而对照组33例患者中有6例（18%）患者血清淀粉酶或脂肪酶升高。有趣的是，在所有组中，血清脂肪酶水平的升高都大于血清淀粉酶水平。为了确定这不是偶然的实验室错误，将血清样本提交给第二个独立实验室，并获得了相同的结果。通常，当发现血清脂肪酶或淀粉酶值升高到任何水平时，停止使用该药物。结论：在许多2型糖尿病患者中，GLP-1受体激动剂和DPP-4抑制剂均与血清脂肪酶水平升高相关，高于血清淀粉酶水平，可能提示胰腺炎症的存在。这一发现是否会像在大鼠模型中报道的那样，潜在地导致急性胰腺炎或慢性胰腺炎，目前尚不清楚。仔细观察服用这些药物的患者可能是谨慎的。（执业医师，2012;18:47 72-477）
Objective: To investigate the effects of glucagonlike peptidase-1 (GLP-1) receptor agonists and dipeptidyl-peptidase-4 (DPP-4) inhibitors on serum amylase and serum lipase levels in patients with type 2 diabetes.Methods: In 90 patients with type 2 diabetes, treatment was initiated with 4 GLP-1 agonist or a DPP-4 inhibitor. A comparison group consisted of 33 patients with type 2 diabetes and similar characteristics who were not prescribed these agents. Baseline serum amylase and lipase levels were measured in all patients and repeated periodically. We determined the percentage of. patients with elevated levels of serum amylase or lipase (or both) in both groups.Results: Among all 90 patients who received a GLP-1 receptor agonist or a DPP-4 inhibitor, 32 (36%) had an increase in serum amylase or lipase (or both) in comparison with 6 of 33 patients (18%) with such increases in the comparison group. Interestingly, the serum lipase levels increased more than the serum amylase values in all groups. To ascertain that this was not a chance laboratory error, serum samples were submitted to a second independent laboratory, and the same results were obtained. Usually, use of the medication was discontinued when serum lipase or amylase values were found to be elevated at any level.Conclusion: Both GLP-1 receptor agonists and DPP-4 inhibitors are associated with increased levels of serum lipase more than serum amylase in many patients with type 2 diabetes, possibly suggesting the presence of pancreatic inflammation. Whether this finding may potentially lead to acute pancreatitis or chronic pancreatitis, as reported in rat models, is currently unknown. Careful observation of patients taking these medications may be prudent. (Endocr Pract. 2012;18:472-477)