Lipase

Lipase-role in the body

Lipase is a digestive enzymeEnzymes are proteins that accelerate chemical reactions in the body. They ensure the occurrence of metabolic processes such as food digestion, energy release, cell formation, and many others. that breaks down fats (triglycerides) into glycerol and fatty acids. Main types and localization:

1. Pancreatic lipase (produced by the pancreas) is the main diagnostic marker
2. Hepatic lipase
3. Lingual lipase (in infants)
4. Vascular endothelial lipase

Main functions:

• Digestion of dietary fats in the intestines
• Participation in lipoprotein metabolism
• Providing absorption of fat-soluble vitamins (A, D, E, K)

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Norm of lipase in the blood test

Age Group	Normal Range (U/L)
Adults	13-60
Children under 18	0-130
Elderly (over 60)	Up to 160

Note: The reference values may differ depending on the study method (immunochemical or colorimetric methods are more often used).

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Symptoms of excess lipase (elevated levels)

Main reasons for the increase:

1. Acute pancreatitis (the level may exceed the norm by 5-10 times):

• Severe shingles pain in the epigastrium
• Nausea and uncontrollable vomiting
• Bloating
• Fatty stele (steatorrhea)

1. Other reasons:

• Chronic pancreatitis
• A cyst or pancreatic cancer
• Obstruction of the pancreatic duct
• Kidney failure
• Perforated stomach ulcer

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Symptoms of lipase deficiency (low level)

Reasons for the decline:

1. Cystic fibrosis
2. Chronic pancreatitis with insufficiency
3. Removal of the pancreas
4. Oncological diseases

Clinical manifestations:

• Steatorrhea (greasy, foul-smelling stools)
• Weight Loss
• Lack of fat-soluble vitamins
• Flatulence and discomfort after fatty foods

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Diagnostic value

Pancreatic lipase – the gold standard for diagnosis:

• Increases 4-8 hours after an attack of acute pancreatitis
• It remains up to 7-14 days
• More specific than amylase

Ratio with amylase:

• For pancreatitis: lipase, amylase
• In case of salivary gland pathologies: amylase↑ ↑, lipase is normal

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What should I do if there are deviations?

With increased lipase:

1. Urgent consultation with a gastroenterologist
2. Ultrasound/CT scan of the pancreas
3. Urinalysis for diastasis
4. Hospitalization for acute pancreatitis

With reduced lipase:

1. Enzyme replacement therapy (Creon, Panzinorm)
2. A fat-restricted diet
3. Taking vitamins A, D, E, and K

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Interesting facts

• Lipase levels are independent of food intake
• In chronic pancreatitis, there may be a norm between exacerbations
• False positive results are possible in 1% of healthy people

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Conclusions

1. Norm: 13-60 U/l for adults
2. Promotion: acute pancreatitis (main cause), tumors, kidney failure
3. Decline: chronic pancreatic insufficiency, cystic fibrosis
4. The most specific marker of pancreatic damage