Document Detail


Elevated amylase and lipase levels in patients using glucagonlike peptide-1 receptor agonists or dipeptidyl-peptidase-4 inhibitors in the outpatient setting.
MedLine Citation:
PMID:  22440997     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 a 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.
Authors:
Howard M Lando; May Alattar; Anuradha P Dua
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists     Volume:  18     ISSN:  1934-2403     ISO Abbreviation:  Endocr Pract     Publication Date:    2012 Jul-Aug
Date Detail:
Created Date:  2012-08-01     Completed Date:  2013-01-03     Revised Date:  2013-03-19    
Medline Journal Info:
Nlm Unique ID:  9607439     Medline TA:  Endocr Pract     Country:  United States    
Other Details:
Languages:  eng     Pagination:  472-7     Citation Subset:  IM    
Affiliation:
Department of Medicine, George Washington University, Washington, District of Columbia, USA. hlando@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adamantane / adverse effects,  analogs & derivatives,  therapeutic use
Adult
Aged
Aged, 80 and over
Diabetes Mellitus, Type 2 / blood,  drug therapy*,  immunology
Dipeptides / adverse effects,  therapeutic use
Dipeptidyl-Peptidase IV Inhibitors / adverse effects*,  therapeutic use
Drug Monitoring
Female
Glucagon-Like Peptide 1 / agonists*
Humans
Hypoglycemic Agents / adverse effects*,  therapeutic use
Lipase / blood
Male
Middle Aged
Pancreas / drug effects*,  enzymology,  immunology
Pancreatic alpha-Amylases / blood
Pancreatitis / chemically induced*,  physiopathology
Peptides / adverse effects,  therapeutic use
Pyrazines / adverse effects,  therapeutic use
Receptors, Glucagon / agonists*
Reproducibility of Results
Severity of Illness Index
Triazoles / adverse effects,  therapeutic use
Venoms / adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Dipeptides; 0/Dipeptidyl-Peptidase IV Inhibitors; 0/Hypoglycemic Agents; 0/Peptides; 0/Pyrazines; 0/Receptors, Glucagon; 0/Triazoles; 0/Venoms; 0/glucagon-like peptide-1 receptor; 141732-76-5/exenatide; 281-23-2/Adamantane; 89750-14-1/Glucagon-Like Peptide 1; 9GB927LAJW/saxagliptin; EC 3.1.1.3/Lipase; EC 3.1.1.3/PNLIP protein, human; EC 3.2.1.1/Pancreatic alpha-Amylases; QFP0P1DV7Z/sitagliptin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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