Effects Of Incretin-based Drugs On Amylase Activity In Patients With Type 2 Diabetes Mellitus

Objective To investigate the effects of incretin-based drugs on serum amylase(AMY),urinary amylase(UAMY)and general biochemical indicators in patients with type 2diabetes mellitus(T2DM).According to body mass index(BMI)or triglyceride(TG)stratification,the levels of AMY and UAMY were observed.Methods From March to September of 2016,320 patients with T2 DM were selected from Department of Endocrinology of Affiliated Hospital of Qingdao University(age from 38 to 70 years old,mean 56.78 years old,duration of disease from 2 to 12 years,mean 5.89years),which were equally and randomly divided into the control group and the observation group.The observation group was given one of incretin-based drugs(saxagliptin,vildagliptin,exenatide or liraglutide)and other hypoglycemic drugs(metformin,acarbose,pioglitazone,insulin,etc)could be added,the control group was only given other hypoglycemic drugs.After 12 weeks,AMY,UAMY,TC,TG,Hb A1 c and other indicators were compared between two groups.The patients of two groups were divided into three layers according to BMI or TG,each layer was observed and analyzed the levels of AMY and UAMY.Results Compared two groups of patients with age,duration of disease,body weight,waist circumference and BMI before treatment,there were no significant differences(P >0.05).After 12 weeks of treatment,8 patients were lost and 152 cases completed treatment in the observation group,10 cases were lost and 150 cases completed treatment in the control group,there were no acute pancreatitis and severe adverse drug reactions in two groups.After treatment,body weight,WC and BMI of the control group were no significant differences(P >0.05),there were significant differences in the observation group(P<0.05),and there were significant differences in the D-values of body weight,WC and BMI(P<0.05).After treatment,HDL,TG,AMY and UAMY of two groups were no significant differences(P >0.05),TC,LDL and Hb A1 c of two groups were significant differences(P <0.05),there were no significant differences in all biochemical indicators between two groups(P >0.05),and there were no significant differences in the D-values of all biochemical indicators(P >0.05).The use of incretin-based drugs in the observation group was as follows,saxagliptin 58 cases(3 cases lost),vildagliptin 56 cases(2 cases lost),exenatide 24 cases(2 cases lost),and liraglutide 22 cases(1 case lost).After treatment,AMY and UAMY in both GLP-1 agonists and DPP-4 inhibitors were no significant differences(P >0.05),AMY and UAMY between GLP-1 agonists and DPP-4inhibitors were no significant differences(P >0.05),and there were no significant differences in the D-values of AMY and UAMY(P >0.05).In the conrtrol group,the levels of AMY and UAMY were increased from A layer to C layer(P <0.05),in the observation group,the levels of AMY and UAMY were increased from A layer to C layer(P <0.05).Conclusion In this study,the treatment of T2 DM patients with GLP-1 agonists or DPP-4inhibitors cannot cause the increase of amylase and the occurrence of acute pancreatitis.But T2 DM patients with hypertriglyceridemia or obesity,the amylase levels may increase with the increase of TG or BMI levels,which should be paid attention to.