Lipase is a glycopotein, produced primarily in the pancreas and to a small degree the mouth and stomach. Pancreatic lipase secreted into the duodenum aides the breakdown of dietary fats and triglycerides into fatty acids and glycerol in the presence of bile salts and colipase. These breakdown products can then be absorbed and transported across the bowel wall into the portal circulation.
The serum lipase test measures the amount of the enzyme lipase in the blood. Elevated levels occur principally from damage of pancreatic acinar cells with resulting release of lipase into the blood stream.
The clinical utility of the lipase test includes:
- To aid in the diagnosis of acute and chronic pancreatitis
- To monitor the treatment of acute pancreatitis
- To evaluate abdominal pain
- To assist in the diagnosis of pancreatic carcinoma
- To distinguish between causes of hyperamylasemia
Additional information
- Serum lipase begins to rise in 2 to 6 hours after pancreatic damage, reaches a maximum in 12 to 30 hours and remains elevated for 8 to 14 days
- The lipase test provides better sensitivity and specificity than the amylase assay, and is best used with serum or urine amylase determination
- Coexistence of increased serum amylase and normal lipase levels may be a helpful clue to the presence of macroamylasemia
- The serum lipase:amylase ratio may help distinguish alcoholic from nonalcoholic pancreatitis
- Interfering factors:
- Anticoagulants like EDTA, citrate, and oxalate
- Endoscopic retrograde cholangiopancreatography
- Related laboratory tests include:
- Alanine aminotransferase
- Alkaline phosphatase
- Amylase
- Aspartate aminotransferase
- Bilirubin
- Ca 19-9
- Calcium (Serum)
- Creatinine
- Fecal fat
-glutamyltrans-peptidase- Mumps serology
- Triglycerides
- White blood cell count
Consult your laboratory for their normal ranges as these may vary somewhat from the ones listed below.
| Conv. Units
(U/L) | SI Units
(µkat/L) |
|---|
| Adults | <160 | <2.67 |
| Critical values | >600 | >10 |
Conditions associated with elevated serum lipase levels include:
- Pancreatic disorders
- Pancreatitis – acute and chronic
- Alcoholic pancreatitis
- Pancreatic carcinoma
- Pancreatic duct obstruction
- Pancreatic cyst or pseudocyst
- Perforated peptic ulcer with chemical pancreatitis
- Cholecystitis
- Chronic renal failure
- Crohn's disease
- Cystic fibrosis
- Diabetes mellitus (ketoacidosis)
- Familial lipoprotein lipase deficiency
- Gastric malignancy
- Hemodialysis
- Peritonitis
- Primary biliary cirrhosis
- Salivary adenitis
- Strangulated or infarcted bowel
- Ulcerative colitis
- Drugs
- Acetaminophen
- Asparaginase
- Azathioprine
- Bethanechol
- Calcitriol
- Cerivastatin
- Chlorothiazide
- Cholinergics
- Cidofovir
- Cimetidine
- Clozapine
- Codeine
- Conjugated estrogens
- Cyclosporine
- Demeclocycline
- Deoxycholate
- Desipramine
- Diazoxide
- Didanosine
- Donepezil
- Doxorubicin
- Enalapril
- Estropipate
- Fluvastatin
- Furosemide
- Glycocholate
- Human growth hormone
- Hydrocortisone
- Ibuprofen
- Indomethacin
- Interferon
- Lisinopril
- Meperidine
- Mercaptopurine
- Mesalamine
- Methacholine
- Methylprednisolone
- Metolazone
- Metronidazole
- Minocycline
- Mirtazapine
- Morphine
- Nabumetone
- Naproxen
- Narcotics
- Nitrofurantoin
- Norfloxacin
- Octreotide
- Oral contraceptives
- Oxaprozin
- Pancreozymin
- Pegaspargase
- Penicillamine
- Pentazocine
- Piroxicam
- Prazosin
- Prednisone
- Quinapril
- Secretin
- Simvastatin
- Sulfamethoxazole
- Sulindac
- Taurocholate
- Trastuzumab
- Tretinoin
- Valproic acid
- Zalcitabine
- Zolmitriptan