Learn about diagnostic lipase testing

Posted by Master, Doctor Do Thi Hoang Ha - Laboratory Department - Vinmec Hai Phong International General Hospital

Lipase test helps diagnose pancreatic diseases accurately and quickly. In some cases, lipase testing is also used in the diagnosis and monitoring of conditions such as cystic fibrosis, Crohn's disease, and celiac disease.

Lipase is an enzyme produced by the pancreas and in humans it is produced only in the pancreas. This enzyme helps convert fats and triglycerides into fatty acids and glycerol. It is transported through the pancreatic duct into the duodenum where it breaks down dietary triglycerides into fatty acids.
Normally, the pancreas only produces enough Lipase to digest food, so Lipase is present in the blood in low concentrations. When a patient has pancreatic diseases such as pancreatitis, cell damage in the pancreas, a stone blocking the pancreatic duct or a pancreatic tumor, the amount of Lipase enzyme being transported into the blood increases, causing lipase levels in the blood to increase. blood increases.

Lipase test is used to measure the activity of Lipase enzyme in the blood and is most used to diagnose pancreatic diseases.
In the most common pathology of the pancreas is acute pancreatitis (with clinical symptoms such as sudden, continuous, severe abdominal pain, spreading to the sides of the ribs and obliquely to the back, vomiting and nausea, fever, abdominal distension...), Lipase levels will increase in the blood within 24 to 36 hours after the onset of acute pancreatitis (ie, after the blood amylase activity increases). Lipase remains elevated until day 14 (i.e., longer than hyperamylase). The average blood Lipase activity will increase by 5-10 times the normal value.

In the diagnosis of acute pancreatitis, the clinician will order both Amylase and Lipase tests at the same time, usually Lipase enzyme levels will increase in parallel with Amylase levels, but Lipase levels return to normal later. Compared with Amylase, Lipase test is valuable in diagnosing late stage pancreatitis. Therefore, Lipase is a test with high sensitivity and specificity compared to the test for measuring Amylase activity in acute pancreatitis.
The test is also used to monitor the treatment of acute pancreatitis, helping the treating doctor to make timely interventions.
In addition, measurement of Lipase activity is a useful test to distinguish abdominal pain due to acute pancreatitis from those of other causes. Lipase activity testing will quickly determine whether the source of abdominal pain is pancreatic or extrapancreatic.

Sometimes the Lipase test is also used to evaluate other conditions such as:
Diagnosis of acute cholecystitis, biliary obstruction Diabetic ketoacidosis Diagnosis of intestinal obstruction, intestinal infarction Perforation due to gastric ulcer stomach - duodenum Chronic liver diseases, alcoholic liver damage Peritonitis Renal failure Diagnosis of cystic fibrosis Diagnosis of Celiac disease, Crohn's disease

Normal value of Lipase enzyme in blood of adults: <60U/L, children <40 U/L. Factors contributing to changes in Lipase test results such as:
Samples with broken red blood cells; Blood lipase activity increases with the intervention of some drugs: Oral contraceptives, angiotensin-converting enzyme inhibitors, corticosteroids, ethanol, beethanecol, antiviral drugs, paracetamol, substances such as morphine, codeine, indomethacin.. Blood lipase activity may be decreased temporarily in the presence of calcium ions or permanently in the presence of permanent damage to Lipase-producing cells in the pancreas (as in cystic fibrosis).

Lipase tests are performed on serum (non-anticoagulant) or plasma (Heparin anticoagulant) samples.
Patients undergoing a lipase test will be asked to stop eating or drinking anything (except water) 8 to 12 hours before the blood draw. The doctor may also ask the patient to provide medications and supplements that the patient is taking and recommend stopping some drugs that may affect the test results.
The nurse will take 2ml of venous blood in the morning and the results will be returned to the patient after one hour.
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SEE ALSO:
Some important laboratory indicators in the diagnosis of acute pancreatitis Complications can be caused by chronic pancreatitis Severe acute pancreatitis symptoms