[Dissociation of serum kinetics of amylase and trypsin following stimulation with secretin and pancreozymin]

Abstract

The diagnostic value of basal serum trypsin and amylase values in the assessment of pancreatic exocrine function is limited. Secretin injection evokes a significantly different response in the serum kinetics of trypsin and amylase, due probably to their difference in molecular weight (21,000 vs 52,000 Daltons). Serum trypsin increases in 70% of people with normal secretin-pancreozymin test after stimulation with secretin, whereas amylase remains unchanged. The post-stimulatory rise in trypsin is lower in mild exocrine insufficiency and almost completely abolished in severe exocrine insufficiency. The diagnosis of severe exocrine insufficiency is confirmed in 93% and that of mild insufficiency in 54% by low basal and post-stimulatory levels of serum trypsin. In diabetics with low basal values the post-stimulatory rise in serum trypsin confirmed normal pancreatic function. The poststimulatory kinetics of serum amylase shows no clear correlation to pancreatic function. From the divergent serum kinetics of trypsin and amylase it may be concluded that trypsin is primarily of ductular and amylase primarily of acinar origin.