LEADER 3-lipase and amylase activity in subjects with type 2 diabetes baseline data from over 9000 subjects in the LEADER trial

William M. Steinberg, Michael A. Nauck, Bernard Zinman, Gilbert H. Daniels, Richard M. Bergenstal, Johannes F E Mann, Lasse Steen Ravn, Alan C. Moses, Mette Stockner, Florian M M Baeres, Steven P. Marso, John B. Buse

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Objectives: This report from the LEADER (Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results) trial describes baseline lipase and amylase activity in type 2 diabetic subjects without acute pancreatitis symptoms before randomization to the glucagonlike peptide analog liraglutide or placebo.

Methods: The LEADER is an international randomized placebo-controlled trial evaluating the cardiovascular safety of liraglutide in 9340 type 2 diabetic patients at high cardiovascular risk. Fasting lipase and amylase activity was assessed at baseline, before receiving liraglutide or placebo, using a commercial assay (Roche) with upper limit of normal values of 63 U/L for lipase and 100 U/L for amylase.

Results: Either or both enzymes were above the upper limit of normal in 22.7% of subjects; 16.6% (n = 1540) hadan elevated lipase level (including 1.2% >3-fold elevated), and 11.8% (n = 1094) had an elevated amylase level (including 0.2% >3-fold elevated). In multivariable regression models, severely reduced kidney function was associated with the largest effect on increasing activity of both. However, even among subjects with normal kidney function, 12.2% and 7.7% had elevated lipase and amylase levels.

Conclusions: In this large study of type 2 diabetic patients, nearly 25% had elevated lipase or amylase levels without symptoms of acute pancreatitis. The clinician must take these data into account when evaluating abdominal symptoms in type 2 diabetic patients.

Original languageEnglish (US)
Pages (from-to)1223-1231
Number of pages9
JournalPancreas
Volume43
Issue number8
DOIs
StatePublished - Nov 10 2014

Keywords

  • Amylase
  • Lipase
  • Pancreatitis
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Endocrinology

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    Steinberg, W. M., Nauck, M. A., Zinman, B., Daniels, G. H., Bergenstal, R. M., Mann, J. F. E., Ravn, L. S., Moses, A. C., Stockner, M., Baeres, F. M. M., Marso, S. P., & Buse, J. B. (2014). LEADER 3-lipase and amylase activity in subjects with type 2 diabetes baseline data from over 9000 subjects in the LEADER trial. Pancreas, 43(8), 1223-1231. https://doi.org/10.1097/MPA.0000000000000229