糖尿病と臨床実践のジャーナル

抽象的な

Increase in Pancreatic Amylase and Lipase during Incretin Therapy is not Associated with Acute Pancreatitis or Pancreatic Cancer Risk in Italian Patients with Type 2 Diabetes

Maietti E, Monesi M, Volpato S and Monda VM*

Aims: To investigate the association of incretino-mimetic drugs use and elevation of pancreatic enzymes and the incidence of pancreatitis and pancreatic cancer in adults with type II diabetes.

Methods: Retrospective study on 2058 patients diagnosed with type 2 diabetes mellitus referring to the diabetologic outpatient services of the health service of the district of Ferrara (Italy), between January 2012 and December 2016. Incident cases of acute pancreatitis and pancreatic cancer were ascertained using hospital discharge charts from all hospitals of the Emilia Romagna region health system.

Results: Of 2058 T2DM patients enrolled in the study, 956 (46.5%) were treated with incretin-mimetics drugs during the observation period. The mean age was 66.8 years, 42.4% were female, 828 patients were treated with DPP-IV inhibitors and 128 with GLP-1 analogues. Patients treated with incretino-mimetics had significantly higher lipases and amylases values compared to control group (lipases, U/L: 47 [31-79] vs. 34 [21-61], p<0.001; amylases U/L: 31 [21-47] vs. 26 [17-41], p<0.001), independent of age, gender and BMI. The GLP-1 treated patients showed significantly higher values of lipases compared to DPP-IV treated patients (45.5 [30-77] vs. 54 [37-85.5], p 0.010). The rates of incidedent cases of acute pancreatites and pancreatic cancer was lower among incretino-mimetics users as compared to controls (p 0.077 and <0.001, respectively.

Conclusion: Incretino-mimetic theraphy is associated with increased levels of serum amylases and lipase but not increased likelihood of acute pancreatites and pancreatic cancer.