Abstract
Aims
While there is plentiful evidence on elevated serum levels of amylase, lipase, and
trypsin in acute illness, low serum levels of these digestive enzymes have been studied
infrequently. The aim was to systematically review published studies on the relationship
between low serum levels of amylase, lipase, or trypsin and metabolic disorders.
Methods
The search was conducted in MEDLINE and Scopus databases. Studies in humans were included
if they reported on the association between serum levels of amylase, lipase, or trypsin
within normal range and metabolic disorders. Random-effects meta-analysis was conducted.
Results
A total of 20 studies encompassing 20,916 participants were included. Compared with
healthy individuals, individuals with type 2 diabetes mellitus (mean difference = −5.3;
p < 0.001), metabolic syndrome (mean difference = −5.1; p < 0.001), and overweight/obesity
(mean difference = −0.8; p = 0.02) had significantly lower serum levels of amylase.
Both individuals with type 1 diabetes mellitus (mean difference = −1.8; p < 0.001)
and type 2 diabetes mellitus (mean difference = −0.8; p < 0.001) had significantly
lower serum levels of lipase compared with healthy individuals. Data on serum trypsin
were not suitable for meta-analysis. In the pooled analysis, individuals with type
2 diabetes mellitus had 3.1-times lower serum levels of amylase, 2.9-times lower serum
levels of lipase, and 2.5-times lower serum levels of trypsin levels than the upper
limits of normal for the three digestive enzymes.
Conclusion
Low serum levels of amylase and lipase are significantly associated with type 2 diabetes
mellitus, type 1 diabetes mellitus, excess adiposity, and metabolic syndrome. The
role of digestive enzymes in the pathogenesis of metabolic disorders warrants further
investigations.
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Article info
Publication history
Published online: December 04, 2019
Accepted:
December 2,
2019
Received in revised form:
November 7,
2019
Received:
October 1,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
