Sarathi Vijaya, Tirupati Sunanda, Sabinkar Gayatri, Mohan Rama
Department of Endocrinology, Vydehi Institute of Medical Sciences and Research Center, Bengaluru, Karnataka, India.
Department of Endocrinology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India.
Int J Appl Basic Med Res. 2023 Apr-Jun;13(2):113-116. doi: 10.4103/ijabmr.ijabmr_503_22. Epub 2023 Jul 17.
Although not definitive, there is small increased risk of acute pancreatitis with the use of dipeptidyl peptidase 4 inhibitors (DPP4i). Hence, there is an interest in the elevation of pancreatic enzymes among type 2 diabetes mellitus (T2DM) patients using DPP4i. However, the studies regarding their association are limited and provide conflicting results. Moreover, there are no such studies among South Indian T2DM patients. Hence, we evaluated the prevalence of hyperamylasemia among South Indian T2DM patients and its association with DPP4i use.
This cross-sectional study was conducted at a tertiary health care center from South India. Adult T2DM patients on stable doses of antidiabetic medications for at least previous 3 months were included in the study. Patients with other types of diabetes mellitus, gall stones, diabetic ketoacidosis, acute illness, chronic kidney disease and untreated hypothyroidism were excluded from the study. All participants were evaluated with glycemic parameters, serum creatinine and serum amylase. Hyperamylasemia was defined as serum amylase ≥220 U/L.
A total of 200 participants were included in the study among whom 93 patients were not on DPP4i whereas 107 were on DPP4i including 41 (38.32%) each on teneligliptin and sitagliptin. Baseline characteristics including glycemic measures were comparable between DPP4i users and nonusers. A total of 14 patients (7%) had hyperamylasemia but the prevalence of hyperamylasemia did not differ between DPP4i users and nonuser (6/107 vs. 8/93, = 0.42).
Asymptomatic hyperamylasemia is not uncommon in South Indian T2DM patients but is not associated with the use of DPP4i.
尽管尚无定论，但使用二肽基肽酶4抑制剂（DPP4i）会使急性胰腺炎的风险略有增加。因此，使用DPP4i的2型糖尿病（T2DM）患者的胰腺酶升高情况受到关注。然而，关于它们之间关联的研究有限且结果相互矛盾。此外，在南印度T2DM患者中尚未有此类研究。因此，我们评估了南印度T2DM患者高淀粉酶血症的患病率及其与使用DPP4i的关联。
这项横断面研究在印度南部的一家三级医疗保健中心进行。研究纳入了至少在过去3个月内服用稳定剂量抗糖尿病药物的成年T2DM患者。患有其他类型糖尿病、胆结石、糖尿病酮症酸中毒、急性疾病、慢性肾病和未经治疗的甲状腺功能减退症的患者被排除在研究之外。所有参与者均接受血糖参数、血清肌酐和血清淀粉酶评估。高淀粉酶血症定义为血清淀粉酶≥220 U/L。
共有200名参与者纳入研究，其中93名患者未使用DPP4i，107名患者使用DPP4i，包括服用替格列汀和西他列汀的各41名（38.32%）。DPP4i使用者和非使用者之间的基线特征（包括血糖指标）具有可比性。共有14名患者（7%）患有高淀粉酶血症，但DPP4i使用者和非使用者之间高淀粉酶血症的患病率无差异（6/107 vs. 8/93，P = 0.42）。
无症状性高淀粉酶血症在南印度T2DM患者中并不罕见，但与使用DPP4i无关。
