Serum Lipase / Amylase Activity Ratio for Screening Insulin Resistance

Abstract

Early diagnosis of insulin resistance (IR) is important to prevent the development of type 2 diabetes mellitus (DM). Type 2 DM is mainly considered as an endocrine disorder however some recent studies show that exocrine functions of the pancreas are insufficient in type 2 DM. Our aim in this study to evaluate the relation of insulin resistance with pancreatic exocrine functions. Fasting glucose, insulin, amylase, lipase, HbA1c, and demographic information of subjects were taken from the laboratory information system. Children and the diabetic subjects were excluded. Included subjects were separated according to the insulin sensitivity status determined by homeostatic model assessment. There were 335 individuals in the insulin sensitive (IS) group, 275 in the moderate IR group, and 164 in the severe IR group. The average age is 45 (34-54). Serum lipase and amylase levels were used as an indicator of pancreatic exocrine functions. Serum amylase, lipase and serum lipase/amylase activity ratio were compared between groups. Serum amylase levels were 67.8, 63 and 65.3 U/L; serum lipase levels were 31, 31 and 25.5 U / L, serum lipase/amylase ratios were 47%, 50% and 38% in the IS, moderate IR and severe IR groups, respectively. There is a significant difference in serum amylase levels between insulin- sensitive (IS) and moderate IR groups (p=0.02) and in serum lipase levels between IS and severe IR, and between moderate IR and severe IR (p<0.001, p<0.001 respectively). When we use serum lipase/amylase activity ratio to compare groups with each other, there is a significant difference between IS and moderate IR, IS and severe IR, and moderate IR and severe IR (p= 0.015, p<0.001, p< 0.001 respectively). Our results show that the exocrine functions of the pancreas are affected in insulin resistance and serum lipase/amylase activity ratio can be used as a new parameter to define and screen insulin sensitivity status of the body