[Blood amylase and lipase in diabetic ketoacidosis]

The relation between increase of amylasaemia and increase of lipasaemia was studied during ketoacidosis in 31 insulin-dependent diabetics. The effects of metabolic disturbances on amylase production during the acute phase of ketoacidosis were also evaluated. The greatest increase of amylasaemia was observed after 24 hours in 17 cases (55%), with return to normal values after 3 to 7 days. Amylasuria was closely correlated with amylasaemia (r = 0.7; P less than 0.01). No correlation was found between hyperamylasaemia and the degree of ketoacidosis, but there was a correlation between plasma osmolality and hyperamylasaemia (r = 0.44; P less than 0.02). The increase of lipasaemia, considered more specific of pancreatic damage, was closely correlated with that of amylasaemia (r = 0.63: P less than 0.01). The electrolyte disturbances associated with ketoacidosis are responsible for cellular damage with release of enzymes in many tissues. The hyperamylasaemia consecutive to pancreatic damage might be of similar origin and aggravated by splanchnic hypoperfusion.