THE MECHANISMS OF HYPERAMYLASEMIA IN LIVER CIRRHOSIS

Abstract

Hyperamylasemia is frequently observed in cirrhotic patients. To clarify the mechanisms of the elevated enzyme activity, we investigated the importance of renal excretion of amylase in these patients.
Upon separation of serum isoamylases with inhibitor method, the amylase levels of pancreatic and salivary type were both elevated in cirrhotic patients as compared with those of nomal controls. However, the ratio of the P/S isozyme were similar in both the cirrhotic patients and the control group. The clearance studies indicated that Cam, Cpam, Csam, Cam/Ccr, Cpam/Ccr and Csam/Ccr were all decreased in cirrhotic patients, and simultaneously the total amount of urinary excretion of these amylases were reduced.
Using polyacrylamidegel electrophoresis of serum amylase, the "slower moving peak" which is distinct from P and S type was detected in the serum of 5 of 29 patients with cirrhosis of the liver. This peak was also present in one of 23 normal sera, however, the amount of "slower moving peak" amylase were small and seemed to be not the major determinant of amylase clearance. We concluded that hyperamylasemia and low Cam/Ccr ratio in cirrhotic patients were mainly on the basis of reduced renal excretion of the enzyme.