Retrospective cohort study to examine the association between serum amylase and the incidence of type 2 diabetes mellitus, Toranomon Hospital Health Management Center Study 23 (TOPICS 23)

Izumi Ikeda; Kazuya Fujihara; Taeko Osawa; Yasunaga Takeda; Mariko Hatta; Yasuhiro Matsubayashi; Satoru Kodama; Yasumichi Mori; Takashi Kadowaki; Ritsuko Honda; Yasuji Arase; Hirohito Sone

doi:10.1136/bmjdrc-2023-003482

Retrospective cohort study to examine the association between serum amylase and the incidence of type 2 diabetes mellitus, Toranomon Hospital Health Management Center Study 23 (TOPICS 23)

BMJ Open Diabetes Res Care. 2023 Jul;11(4):e003482. doi: 10.1136/bmjdrc-2023-003482.

Affiliations

¹ Department of Hematology, Endocrinology and Metabolism, Niigata University Facility of Medicine, Niigata, Japan.
² Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo, Japan.
³ Health Management Center, Toranomon Hospital, Tokyo, Japan.
⁴ Department of Hematology, Endocrinology and Metabolism, Niigata University Facility of Medicine, Niigata, Japan sone@med.niigata-u.ac.jp.

Abstract

Introduction: Low serum amylase values are cross-sectionally associated with the prevalence of type 2 diabetes mellitus (T2DM) but have not been shown to be longitudinally associated with its incidence. This retrospective cohort (ie, historical cohort) study aimed to examine the association of previously lowered levels of serum amylase with incident T2DM.

Research design and methods: Examined were 8316 individuals who had annual health examinations for 6 years (ie, 7 times) at the Toranomon Hospital Health Management Center. The trajectory of serum amylase as the study exposure was classified into two elements: (1) serum amylase level at entry and (2) change in serum amylase, which was expressed as the annual change rate. The annual change rate was calculated by dividing the change in the amylase values according to follow-up periods. Regression analyses were performed to examine the association between low and decreased levels of serum amylase and the incidence of T2DM.

Results: Analyzed were 6917 individuals who had not developed T2DM within 1 year after cohort entry. T2DM thereafter occurred in 1021 patients. Cox regression indicated that the adjusted HR (95% CI) for incident T2DM for amylase ≤57 IU/L (quintile (Q) 1) was 0.97 (0.84 to 1.13) compared with amylase ≥58 IU/L (Q2-Q5). Logistic regression indicated that the adjusted OR (95% CI) for an annual change rate of amylase ≤-2.0% (Q1) vs ≥-1.9% (Q2-Q5) was 3.53 (3.00 to 4.16). The adjusted ORs were consistently significant throughout sensitivity analyses according to baseline amylase and the combination of age, body mass index, and hemoglobin A1c.

Conclusions: Results showed that not low but previously decreased serum amylase was a risk factor for T2DM, suggesting the significance of periodic examinations of serum amylase values to detect individuals at high risk of T2DM.

Keywords: cohort studies; diabetes mellitus, type 2; primary prevention; risk factors.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Amylases
Diabetes Mellitus, Type 2* / epidemiology
Hospitals
Humans
Incidence
Retrospective Studies

Substances

Amylases