Diagnostic Use
See “Interpretation” section below
Interpretation
Serum lipase originates mostly from pancreatic acinar cells. Normally >99% of pancreatic lipase is secreted into the pancreatic duct and <1% reaches circulation. In acute pancreatitis, more pancreatic lipase is released into circulation.
Its plasma half life is around 7-13 hours. It rises within 4-8hrs from onset, peaks at 24hrs and remains elevated for 8-14 days.
Lipase is a better diagnostic marker for acute pancreatitis than total amylase as lipase generally demonstrates
– higher magnitude of rise above upper reference limit (about 4.5x more than amylase in pancreatitis)
– an earlier rise from onset (in some cases)
– a more prolonged rise – particularly useful for late presenters
– elevation in alcohol related acute pancreatitis while amylase is typically normal or only minimally raised.
– less frequently and less significantly influenced by renal failure
– not raised in macroamylasaemia
– not elevated in salivary gland or tubo-ovarian diseases
It is uncertain as to whether lipase has better sensitivity than amylase in hypertriglyceridaemia related acute pancreatitis where both amylase and lipase can be falsely low.
Note that lipase is not 100% specific. Similar to amylase, it can also be raised in liver, stomach and intestinal pathologies including perforation/ /infarction/inflammation/trauma, esophagitis, acute cholecystitis and some cases of diabetic ketoacidosis without demonstrable pancreatitis. Specificity for acute pancreatitis improves when 3x above upper reference limit is used.
Test Method
Principle: Enzymatic colorimetric assay
Analyser: Roche Diagnostics Cobas c703
Reagent: LIPC