Dange Nimisha Shankar, Oza Chirantap, Khadilkar Vaman, Gondhalekar Ketan, Yewale Sushil, Khadilkar Anuradha
Department of Growth and Pediatric Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India.
Interdisciplinary School of Health Sciences, Savitribai Phule University, Pune, Maharahstra, India.
J Pediatr Endocrinol Metab. 2024 Dec 24;38(2):146-154. doi: 10.1515/jpem-2024-0314. Print 2025 Feb 25.
Exocrine pancreatic insufficiency has been demonstrated in type 1 diabetes (T1D); lower concentrations of pancreatic enzymes have been associated with metabolic risk (MR). Influence of puberty and MR factors on serum concentrations of amylase and lipase remain unexplored in Indian youth with T1D. 1) To characterize and predict determinants of serum amylase and lipase concentrations in adolescents/youth with T1D. 2) To assess relationship between amylase, lipase, and prevalence of MR.
Cross sectional, observational study on 291 (155 girls) adolescents/youth (10-24 years) with T1D. History, examination, body composition, biochemistry (glycated hemoglobin [HbA1c], thyroid stimulating hormone [TSH], lipids).
Mean age, diabetes duration and HbA1c were 15.3, 7.0 years and 10.0 ± 2.1, respectively. Relative risk of lower amylase/higher lipase concentrations (<median) in participants with poor glycemic control (HbA1c>9.5 %) was 1.42 and 1.34, respectively, though these did not reach statistical significance. In pubertal participants, amylase was lower and lipase higher; association was not found with MR. Higher TSH and lower serum calcium were significantly associated with higher lipase (p<0.001).
We have characterized amylase and lipase concentrations across puberty; poor glycemic control tended to be associated with lower amylase and higher lipase, though these findings did not reach statistical significance. Amylase and lipase concentrations should be monitored in Indian adolescents with T1D, particularly in those with poor metabolic control, puberty, uncontrolled hypothyroidism, or reduced calcium intake, while further longitudinal and larger studies are needed to generalize these findings.
1型糖尿病（T1D）患者已被证实存在外分泌性胰腺功能不全；胰腺酶浓度降低与代谢风险（MR）相关。在患有T1D的印度青少年中，青春期和MR因素对血清淀粉酶和脂肪酶浓度的影响尚未得到研究。1）描述并预测青少年/T1D青年血清淀粉酶和脂肪酶浓度的决定因素。2）评估淀粉酶、脂肪酶与MR患病率之间的关系。
对291名（155名女孩）10 - 24岁的T1D青少年/青年进行横断面观察性研究。收集病史、体格检查、身体成分、生化指标（糖化血红蛋白[HbA1c]、促甲状腺激素[TSH]、血脂）。
平均年龄、糖尿病病程和HbA1c分别为15.3岁、7.0年和10.0±2.1。血糖控制不佳（HbA1c>9.5%）的参与者中，淀粉酶浓度降低/脂肪酶浓度升高（<中位数）的相对风险分别为1.42和1.34，尽管这些未达到统计学意义。在青春期参与者中，淀粉酶较低而脂肪酶较高；未发现与MR有关联。较高的TSH和较低的血清钙与较高的脂肪酶显著相关（p<0.001）。
我们已描述了青春期期间淀粉酶和脂肪酶的浓度；血糖控制不佳往往与较低的淀粉酶和较高的脂肪酶有关，尽管这些发现未达到统计学意义。对于患有T1D的印度青少年，应监测淀粉酶和脂肪酶浓度，尤其是那些代谢控制不佳、处于青春期、甲状腺功能减退未得到控制或钙摄入减少的青少年，同时需要进一步的纵向和更大规模研究来推广这些发现。
