- Red top, tiger top, or gel barrier tube
- 5-7 mL of venous blood
Additional information
- 8 hrs of fasting before test
- Handle sample gently to prevent Hemolysis
- Store refrigerated 2-8°C or frozen
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
- Type I Diabetes Mellitus
- Cystic fibrosis with pancreatic insufficiency
- Drugs that may decrease lipase levels include:
- Calcium
- Hydroxyurea
- Mesalamine
- Protamine
- Saline
- Somatostatin
- Augarten A et al. Serum lipase levels pre and post Lunch meal: evaluation of exocrine pancreatic status in cystic fibrosis. Int J Clin Lab Res.1998;28(4):226-9
- Janice M et al. Clinical Significance of Increased Lipase Levels on Admission to the ICU.. Chest.2005;127:246-250.
- Laboratory Corporation of America. Lipase, Serum. [Homepage on the internet]© 2003. Last accessed on November 2, 2006. Available at URL: http://www.labcorp.com/datasets/labcorp/html/chapter/mono/pr006400.htm
- LabTestsOnline®. Lipase. [Homepage on the Internet] ©2001-2006. Last reviewed on November 26, 2002. Last accessed on November 2, 2006. Available at URL:http://www.labtestsonline.org/understanding/analytes/lipase/test.html
- Luca F et al. Pancreatic Hyperenzymemia: Clinical Significance and Diagnostic Approach. JOP. J Pancreas (Online) 2005; 6(6):536-551.
- Panteghini M et al. Measurement of pancreatic lipase activity in serum by a kinetic colorimetric assay using a new chromogenic substrate. Ann Clin Biochem. 2001 Jul;38(Pt 4):365-70.
- Reddymasu S et al. Elevated lipase and diabetic ketoacidosis associated with aripiprazole. JOP. 2006 May 9;7(3):303-5.
- Reuss R et al. The expression of the carboxyl ester lipase gene in pancreas and pancreatic adenocarcinomas. Int J Oncol. 2006 Sep;29(3):649-54.
- Skrha J et al. Serum lipase, isoamylase and pancreatic function test (PFT) in juvenile-onset insulin-dependent diabetes mellitus. Acta Diabetol Lat. 1983 Oct-Dec; 20(4):357-61.
- Smotkin J et al. Laboratory diagnostic tests in acute Pancreatitis. J Clin Gastroenterol. 2002 Apr; 34(4):459-62.
- UTMB Laboratory Survival Guide®. LIPASE, serum. [Homepage on the Internet]© 2006. Last reviewed on February 2006. Last accessed on November 21, 2006. Available at URL: http://www.utmb.edu/lsg/LabSurvivalGuide/chem/LIPASE_serum.html