Serum amylase in bulimia nervosa: Clinical status and pathophysiology

Elevations of serum amylase have been reported in 25–60% of bulimics. This increase in amylase appears to derive from the nonpancreatic fraction of serum amylase and thus underscores its likely association with previous clinical descriptions of parotid gland enlargement among bulimics. The value of measurement of serum amylase as an index of clinical symptomatology in bulimia is currently limited because of substantial overlap of amylase levels in patients and normals, and because of variability in correlations between amylase levels and symptom severity. This article reviews the physiology of amylase secretion from the salivary glands and, in light of previous studies of physiologic alterations in bulimia, assesses factors that may contribute to variance in amylase levels in bulimics. Controlling for these variables in future studies may yield more useful clinical information. © 7992 lohn Wiley & Sons, Inc.