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  Back Blood-tests Explained


Lipase


At a Glance

Why Get Tested?

Primarily to diagnose and monitor acute pancreatitis; also sometimes to diagnose and monitor chronic pancreatitis or other pancreatic diseases

When to Get Tested?

When you have symptoms of a pancreatic disorder, such as severe abdominal pain, fever, loss of appetite, or nausea

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?

None

The Test Sample

What is being tested?

Location of the pancreas

Lipase is one of several enzymes produced by the pancreas to help digest dietary fats. This test measures the amount of lipase in the blood.

Lipase is transported through the pancreatic duct and into the first part of the small intestine (duodenum), where it helps break down dietary triglycerides (a form of fat) into fatty acids.The pancreas is the primary source of lipase, but cells in other areas of the body involved with digestion and nutrient absorption also produce lipase, including those in the tongue, stomach and liver.

Lipase is usually present in the blood in small quantities. When cells in the pancreas are injured, like with pancreatitis, or when the pancreatic duct is blocked by a gallstone or, in rare cases, by a pancreatic tumor, increased amounts of lipase enter the blood and result in higher concentrations in the blood.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

How is it used?

The blood test for lipase is most often used, along with an amylase test, to help diagnose and monitor acute pancreatitis. It may also be used to diagnose and monitor chronic pancreatitis and other disorders that involve the pancreas but is not as useful of a test for these conditions because lipase levels remain elevated for longer periods and may not reveal clinical progress.

Lipase testing is also occasionally used in the diagnosis and follow-up of cystic fibrosis, celiac disease, and Crohn disease.

When is it ordered?

A lipase test may be ordered when a person has symptoms of acute pancreatitis or another pancreatic disorder, such as:

  • Severe abdominal or back pain
  • Fever
  • Loss of appetite
  • Nausea

It may also be ordered at intervals when a health practitioner wants to monitor someone with a pancreatic condition to evaluate the effectiveness of treatment and to determine whether the lipase levels are increasing or decreasing over time.

What does the test result mean?

A high lipase level in the blood may indicate the presence of a condition affecting the pancreas.

In acute pancreatitis, lipase levels are frequently very high, often 5 to 10 times higher than the highest reference value (often called the upper limit of normal). Lipase concentrations typically rise within 4 to 8 hours of an acute pancreatic attack and remain elevated for up to 7 to 14 days. Lipase levels cannot be used to determine the severity of an acute pancreatic attack.

Concentrations may also be increased with pancreatic duct obstruction, pancreatic cancer, and other pancreatic diseases as well as with gallbladder inflammation or kidney disease.

A low level of lipase in the blood may indicate permanent damage to the lipase-producing cells in the pancreas. This can occur in chronic diseases that affect the pancreas such as cystic fibrosis.

Is there anything else I should know?

When acute pancreatitis occurs, lipase levels usually rise in about the same time as blood amylase concentrations, about 4-8 hours, but lipase levels will remain elevated longer than amylase levels. Lipase testing is thought to be more reliable than amylase testing for the initial diagnosis of acute pancreatitis and is also more sensitive to detecting acute pancreatitis caused by alcohol consumption.

Drugs that may increase lipase levels include pain medications like codeine, indomethacin, and morphine, birth control pills, thiazide diuretics, and cholinergic drugs, among others.



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