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Low and high pancreatic amylase is associated with pancreatic cancer and chronic pancreatitis

  • GASTRO-INTESTINAL EPIDEMIOLOGY
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Abstract

Incidences of pancreatic cancer and acute and chronic pancreatitis are rising globally, and often no curative treatment is available at the time of diagnosis. We tested the hypothesis that low and high plasma concentrations of pancreatic amylase are associated with increased risk of pancreatic cancer, acute pancreatitis, and chronic pancreatitis in the general population. We included 101,765 individuals (55% women) aged 20–100 years from the Copenhagen General Population Study with baseline measurements of plasma pancreatic amylase. After recruitment in 2004–2015 during a median 9 years of follow-up (range 0–15), we collected information about diagnoses of pancreatic cancer, acute pancreatitis, and chronic pancreatitis from the national Danish Patient Registry, the national Danish Cancer Registry, and the national Danish Causes of Death Registry. The median age was 58 years (interquartile range: 48–67) and the median plasma pancreatic amylase 32 U/L (26–40). During follow-up, 442 individuals were diagnosed with pancreatic cancer, 282 with chronic pancreatitis, and 401 with acute pancreatitis. Compared to individuals with pancreatic amylase levels in the 41st–60th percentiles, those with extreme low (1st–2.5th percentiles) and extreme high (97.5th–100th percentiles) pancreatic amylase had hazard ratios of 2.4 (95% confidence interval; 1.6–3.6) and 2.2 (1.4–3.7) for pancreatic cancer, of 1.8 (1.1–3.3) and 3.2 (1.8–5.6) for chronic pancreatitis, and of 1.1 (0.6–1.8) and 1.5 (0.8–2.7) for acute pancreatitis, respectively. In apparently healthy individuals from the general population, extreme low and extreme high plasma pancreatic amylase were associated with 2–threefold higher risk of both pancreatic cancer and chronic pancreatitis.

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Data will be made available upon reasonable request to corresponding author.

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Acknowledgements

We would like to thank staff and participants from the Copenhagen General Population Study for their valuable contributions.

Funding

This work was funded by the Novo Nordisk Foundation, Denmark, the Independent Research Fund Denmark, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark, and Chief Physician Johan Boserup and Lise Boserup’s Fund, Denmark. The Copenhagen General Population Study was supported by Herlev and Gentofte Hospital, Copenhagen University Hospital, the Danish Heart Foundation, the Danish Medical Research Council, the Copenhagen County Foundation.

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Authors and Affiliations

  1. Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark

    Signe E. J. Hansen, Anne Langsted, Anette Varbo, Christian M. Madsen & Børge G. Nordestgaard

  2. The Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark

    Signe E. J. Hansen, Anne Langsted, Anette Varbo, Christian M. Madsen, Anne Tybjærg-Hansen & Børge G. Nordestgaard

  3. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200, Copenhagen, Denmark

    Signe E. J. Hansen, Anne Langsted, Anette Varbo, Christian M. Madsen, Anne Tybjærg-Hansen & Børge G. Nordestgaard

  4. Department of Clinical Biochemistry, Section for Molecular Genetics, Copenhagen University Hospital, Blegdamsvej 9, 2100 Rigshospitalet, Copenhagen, Denmark

    Anne Tybjærg-Hansen

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Contributions

SEJH, AL, and BGN had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analyses. Study concept and design: SEJH, AL, and BGN. Acquisition, analyses and interpretation of data: SEJH, AL, and BGN. Drafting of manuscript: SEJH. Critical revision of the manuscript for important intellectual content: AL, AV, CMM, ATH, and BGN. Statistical analyses: SEJH and AL. Study supervision: AL, AV, CMM, ATH, and BGN.

Corresponding author

Correspondence to Børge G. Nordestgaard.

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Conflict of Interest

BGN reports consultancies or talks sponsored by AstraZeneca, Sanofi, Regeneron, Akcea, Amgen, Kowa, Denka, Amarin, Novartis, Novo Nordisk, Esperion, and Silence Therapeutics. ATH reports consultancies for AstraZeneca, Silence Therapeutics, Novartis, Sanofi, Akcea, and Draupnir Bio. AV and CMM are currently employed at Novo Nordisk. SEJH and AL have no conflicts of interest.

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The study was conducted in accordance with the Declaration of Helsinki and approved by local institutional reviews boards and Danish ethical committees (H-KF-01–144/01). Consent to participate: Written informed consent was obtained from all individuals.

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Hansen, S.E.J., Langsted, A., Varbo, A. et al. Low and high pancreatic amylase is associated with pancreatic cancer and chronic pancreatitis. Eur J Epidemiol 36, 975–984 (2021). https://doi.org/10.1007/s10654-021-00801-0

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