Low serum AMY is commonly observed in people with a history of pancreatitis, which is a well-known predictor of T2DM. However, few longitudinal studies investigated whether low AMY could be predictive of T2DM, especially considering the effects of baseline HbA1c. Also, it is unclear if a change in AMY is predictive of incident T2DM. Thus, we investigated the impact of AMY and its chronological change on the risk of T2DM considering baseline HbA1c. Analyzed were 5306 individuals who had health examinations yearly for 7 y. We monitored the change in AMY values between baseline 1 (first visit) and baseline 2 (2 y later) and ratio of baseline 2 to baseline 1. During the 5-y follow-up, T2DM occurred in 716 patients. Multivariate Cox analysis showed that both a lower AMY at baseline 2 (HR of Quintile 1, 1.44[1.11-1.88] vs. Q5 as ref.) and a larger AMY decline from baseline 1 (HR of <85%, 1.37[1.01-1.87] vs. ≥115% as a ref.) were independent and significant predictors for incident T2DM. In a stratified analysis of 15 groups divided according to the combination of AMY at baseline 2 and chronological change, those with the lowest AMY at baseline 2 and the largest decline in AMY had a significantly increased risk for incident T2DM (Fig. 1 HR of Quintile 1, < 89.9%, 1.57[1.11, 2.23] vs. Q3/≥100% as ref.). These findings imply the clinical relevance of using the AMY level and its chronological changes to assess risk of incident T2DM.


D. Ishii: None. K. Fujihara: None. R. Nedachi: None. M. Harada: None. Y. Matsubayashi: None. K. Saito: None. S. Kodama: None. R. Yamamoto-Honda: None. Y. Arase: None. H. Sone: Research Support; Self; Astellas Pharma Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Daiichi Sankyo Company, Limited, Kowa Pharmaceutical Europe Co. Ltd., Kyowa Hakko Kirin Co., Ltd., Novo Nordisk Inc., Ono Pharmaceutical Co., Ltd., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Teijin Pharma Limited.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.