To clarify the diagnosis of various diseases, a blood test for lipase levels is often prescribed. What is this indicator?

Lipase is a digestive enzyme produced by several internal organs of a person to dissolve, break down into fractions and assimilate fats by the digestive system. Depending on the organ producing this enzyme (or enzyme), there are several of its varieties.

Types of lipase and its purpose

In the human body, lipase is produced in several organs - lungs, liver, pancreas, intestines. Accordingly, the following varieties of this enzyme are distinguished:

• pulmonary;
• leukocyte;
• pancreatic;
• gastric;
• intestinal.

Infants have glands in their mouths that produce what is known as lingual lipase, which helps break down the fat in breast milk immediately after it has been swallowed. As the child grows up, the glands atrophy.

The most important clinical significance is attached to pancreatic lipase, the norm of which in the blood serum is always higher than other types of the enzyme. Produced by the pancreas, it enters the intestines along with pancreatic juice and takes an active part in digestion.

Normally, the content of this type of enzyme in the blood is practically unchanged. If the pancreatic parenchyma is damaged (for example, during an acute attack of pancreatitis), following the destruction of pancreatic cells, a massive release of the enzyme into the circulatory system occurs. Therefore, the analysis for the level of lipase in the blood serum is the most specific study in the diagnosis of acute attacks of pancreatitis.

Norms of lipase in the blood

The interpretation of research results in a biochemical blood test is guided by the established norms.

A characteristic feature of the enzyme is that its normative indicators are the same for men and women. The normal content of the pancreatic variety of this enzyme ranges from 13 to 60 units per milliliter of blood.

In what cases is the analysis assigned?

Indications for prescribing an analysis for the level of lipase in the blood may be the attending physician's suspicions of the development of the following pathologies:

• acute pancreatitis - as a rule, the most effective venous blood sampling, taken on the third day after the onset of the attack, since it is at this time that the maximum increase in the level of pancreatic lipase is observed;
• chronic pancreatitis - the indicators for the chronic form are not so pronounced, since the long-term inflamed pancreas loses its ability to produce enzymes;
• mumps ("mumps") - a disease that is dangerous for its complications in both children and adults, for example, inflammation of the testes in men, damage to the ovaries and mammary glands in women.

Increased lipase is observed in tumor diseases in the pancreas, and in pathologies of the gallbladder and other organs. As a rule, the analysis for the level of this enzyme is performed with a simultaneous examination of blood for other indicators, in particular for amylase - an enzyme that breaks down glycogens and starches.

What does the increase in lipase in the blood say?

The reasons for the increase are most often the above-mentioned and other diseases:

• various forms of pancreatitis, pancreatic necrosis;
• mumps;
• intrahepatic cholestasis;
• peritonitis;
• acute renal pathology.

When interpreting the results of the study, some features of the indicators should be taken into account depending on the form of the disease:

• with edematous pancreatitis, the lipase level practically does not deviate from the norm;
• with fatty pancreatic necrosis, there is an average increase in the level of the enzyme;
• hemorrhagic pancreatic necrosis provokes an excess of the norm by 3.5 times.

Such a high content of the enzyme in the serum persists for 1-2 weeks, after which there is a tendency to decrease (a decrease in the level from a 20-fold increase to a 3-fold increase is considered normal). Long-term preservation of high lipase values ​​when the norm is exceeded by 10 times or more is considered an extremely unfavorable prognosis of the disease.

In women, a frequent reason for an increase in lipase is long-term use of certain drugs, mainly analgesics, barbiturates, and some antibiotics.

The research results can be influenced by such factors as the patient's emotional state, physical or psychological overwork, stress.

When lipase levels are low

The reasons for a low enzyme level can mean such dangerous predictions as:

• the development of a malignant tumor in any organ other than the pancreas;
• the development of cystic fibrosis, cystic fibrosis - a severe genetic disease with pathological damage to the glands of external secretion (usually the lungs);
• the development of a perforated stomach ulcer;
• intestinal obstruction;
• peritonitis;
• inflammatory and cystic lesions of the gallbladder and pancreas.

In addition to these reasons, low lipase levels can be caused by surgical intervention on the pancreas or excess triglycerides in the blood, a characteristic phenomenon with an improper diet with a predominance of fatty foods, or caused by hereditary hyperlipidemia. Decreased lipase may also indicate the transition of acute to chronic pancreatitis.

Of course, all these assumptions can become diagnoses only on the basis of the results of additional studies and the study of the patient's history by a specialist. Therefore, the task of the patient himself is to undergo all the examinations prescribed by the doctor on time, to take tests in compliance with all recommendations for limiting the norms of eating, drinking alcoholic beverages and quitting smoking in the next half hour before donating blood.

Complex food entering our body cannot be accepted by the digestive system in its pure form. First, it must be split into smaller components. This is done by enzymes: amylase, lipase, protease, which are naturally produced by tissues. If their production is not enough, the doctor may prescribe an additional intake of a course of enzymes. By the level of natural enzymes in the blood, it is sometimes possible to make a preliminary assessment of some organs, for example, the pancreas.

If lipase is elevated in the blood, the reasons may be hidden in diseases of varying severity in the body. But before listing the reasons for the increase or decrease in lipase in a diagnostic form, it is worthwhile to understand what it is in general, what are the functions and norms of lipase in humans.

What is lipase?

It is a digestive enzyme belonging to the class of hydrolases. Probably, such a definition did not explain much to you. To put it more simply, lipase is a protein compound that is produced in several parts of our body in order to play a role in a number of processes, including:

• Splitting and fractionation of fats. This is their main function;
• Participation in obtaining energy by the body;
• Participation in the assimilation of certain vitamins and fatty acids;

Where does lipase come from?

Depending on the tissues in which lipase is produced, it differs slightly in function, although their main role - the breakdown of fats remains unchanged. Lipase is produced:

1. Pancreas

This is the so-called pancreatic lipase, normally in the blood it is found in the greatest amount in comparison with other types.

1. Lightweight;
2. Oral cavity of babies.

In this case, they speak of lingual lipase, its main role is to help break down the fats supplied with breast milk.

1. The liver;

This lipase regulates the level of lipids in plasma, and without it, the assimilation of certain compounds (for example, chylomicrons) is impossible.

1. Intestines;
2. Stomach

Here lipase further stimulates the destruction of oil tributyrin to obtain more assimilable substances.

Pancreatic lipase is considered to be of greatest importance. Its level suggests the presence of pancreatitis, its form and complications.

However, based only on the amount of pancreatic lipase, it is premature to draw a conclusion about the presence or absence of certain diseases. A comprehensive examination of the patient is required. Additionally, an analysis for amylase (an enzyme that breaks down starch) can be prescribed, which also plays a significant role when it comes to diseases of the pancreas. More detailed features of an enzyme such as amylase were discussed in our other article.

Blood rate

If we are talking about deviations up and down, there is a numerical value for the amount of lipase taken as the norm.

Up to 18 years, it is permissible to have 0-130 units of lipase in 1 ml of blood; for older people, this interval expands to 190 units.

The rate of lipase in the blood in women does not differ from that characteristic of men.

Compared to blood amylase, lipase can remain normal in some liver diseases, ectopic pregnancy, and other dangerous conditions, which makes lipase tests specific.

Lipase is elevated in the blood

For the doctor, this is valuable diagnostic information, which can be used to suggest further examination or treatment. Diseases in which the level of this enzyme in the blood increases can be as follows:

• Acute pancreatitis;
• Cholecystitis;
• Endocrine diseases;
• Cholestasis;
• Parotitis;
• Heart attack;
• Obesity;
• Pancreatic oncology;
• Gout;
• Intestinal obstruction;
• An ulcer of the stomach or other tissues;
• Taking a number of medications;

It is also worth pointing out that an increase in blood lipase accompanies injuries and fractures.

The development of pancreatitis does not occur immediately, lipase activity can be detected only on the third day, while lipase is slightly increased on the first and second days. There are additional nuances in the diagnosis of pancreatic diseases. For example, with fatty pancreatic necrosis, blood lipase will be normal, and with acute pancreatitis, it more than triples. Acute pancreatitis develops rapidly, and lipase begins to increase sharply already 2-5 hours after the defeat of the gland.

Lipase is lowered in the blood

Another variant of lipase deviation from the norm is its reduction. Low blood levels of this enzyme may indicate one of the following conditions:

1. Cancer tumor of any localization, except for the pancreas itself.
2. Improper nutrition with an excess of fatty food.
3. Hereditary feature: high level of lipids in the blood.
4. The transition of acute pancreatitis to the chronic stage.
5. Removal of the pancreas.
6. Cystic fibrosis.
7. Hereditary hyperlipidemia.

Preparation for enzyme analysis

Before donating blood for lipase analysis, it is necessary to give up fatty, spicy and too spicy food for a day. The analysis is given in the morning on an empty stomach.

Today, the enzymatic method for the determination of lipase is widespread, but there is also an immunochemical one. They differ in mechanism and requirements for medical personnel.

In rare cases, lipase analysis is not performed under the conditions described above, without prior minimal preparation of the patient. This is done if an urgent result is needed.

If you still have questions about what lipase is in a biochemical blood test, leave them in the comments.

The concentration of lipase in the blood is a digestive enzyme that processes and breaks down fats in the body. It regulates many processes in the body, and its rate practically does not differ in the blood of women and men. Lipase its rate in the blood should be in what volumes? When to get tested - what symptoms should prompt you?

Lipaza - what is it and what does it do?

It is a protein compound that dissolves in liquids and is produced by some groups of human internal organs. She is responsible for a variety of actions:

• Separation, breakdown and processing of fats;
• Assimilation of certain fatty acids and vitamins;
• Energy exchange work.

In addition, the place where the enzyme is produced imposes its own differences, therefore, the function of the enzyme is somewhat different in subordination from its localization:

1. The highest lipase concentration in the blood is located much more than in other organ systems. It turns out to be in a passive form in the pancreas, but, reacting with the enzymes available there, it turns into an active one. This work of lipase is pancreatic and performs the most important work there, promoting the decomposition of complex fats into simple substances.
2. In the liver, lipase is involved in regulating the level at which plasma lipids are located, and also assists in the absorption of lipoproteins and chylomicrons. This function of lipase is called hepatic.
3. In the stomach, lipase performs a fat-breaking function, being gastric lipase.
4. Newborns have their own lipase called lingual lipase. It is located in the baby's mouth and helps to break down the enzymes coming with milk.
5. Lipase is also found in the lungs, but in insignificant quantities.

Normal lipase values

The amount of lipase in the blood can be determined only by passing a blood lipase test. Its normal amount does not change depending on the gender of the patient, only the age of the person matters. From the moment of birth until the age of 18, the child should have a concentration of up to 131 U / ml. After a person reaches the age of 18, the amount of lipase in the blood increases slightly and can reach 191 U / ml.

If the patient does not have a pathology of the stomach or other digestive organs, then the indicators of digestive enzymes change only in minimal volumes. If the gastrointestinal tract is damaged, then parts of the diseased organ are gradually split and a large release into the blood of an enzyme that breaks down fat cells is provoked. Often this happens not only with injuries, but also with exacerbations of diseases such as pancreatitis, gastric ulcer and other similar diseases.

When to get tested

Biochemical studies show only the amount of lipase in the blood in the pancreas, since it is found in small volumes in other organs. This biomaterial is taken first of all in case of malfunctions in the digestive tract or the following problems:

• Any form of pancreatitis;
• Mumps threatening infertility;
• Tumor formations in the digestive tract;
• Gallbladder pathologies and other serious disorders in the work of the digestive tract.

In addition to this analysis, it is also worth taking an analysis for the amount of amylase - an enzyme that is responsible for the breakdown of glycogen and starch in the body.

Pancreatitis and lipase elevation

For what reasons can the norm be exceeded

The lipase indicator, which is above the norm, indicates the presence in the body of inflammatory processes in the organs of the digestive system, in the acute form of diseases and infections in the pancreas in the first place. Also, diseases leading to an increase in the enzyme include:

• Exacerbation of the patient's chronic disease of the pancreas or its acute inflammation;
• Mumps in the third week of illness;
• Pancreatic necrosis;
• Tumor formations of any nature - both cancerous and non-fatal;
• Ulcer in the gastrointestinal tract;
• Bowel obstruction problems;
• Incomplete work of one or both kidneys;
• Colic that forms in the gallbladder;
• Subhepatic hepatitis and cholestasis;
• Autoimmune diseases of any form and phase;
• Peritonitis;
• Obesity.

In addition, in women, an increase in the level of lipase in the blood can be provoked by drugs taken both under the supervision of a doctor and by him. These include any analgesic drugs, indomethacin and heparins. In this case, you can achieve a decrease in concentration simply by stopping the drug intake.

Also, fractures of tubular bones can affect an increase in the concentration of lipase in the blood, since they contain a large amount of fat. Such an education is dangerous to health, as it can provoke the onset of a fatty embolism.

In order for the study to be as accurate and correct as possible, it is advisable to conduct it on the third day from the onset of the disease. An elevated lipase level is usually diagnosed for up to 14 days, after which it gradually decreases. Exceeding this indicator for more than two weeks is considered an unfavorable factor.

Why there may be a lower rate

Lipase levels below normal may also indicate a disruption in the digestive tract and dangerous pathologies of the whole organism. Among such deviations, one can indicate a cancer tumor of any location and size, gastric ulcer with perforation, the formation of new or inflammation of existing cysts in the gallbladder or pancreas, the formation of peritonitis, intestinal obstruction, removal or suturing of the stomach, intestines or pancreas, the appearance or exacerbation cystic fibrosis.

In addition, a decrease in the amount of lipase in the blood is manifested at the time of the transition of the disease from the acute phase to the chronic form. Only a doctor can confirm or deny the presence of pathology, the transition from one stage to another, and establish the correct diagnosis on the basis of blood tests, ultrasound and other necessary studies.

The tasks that the patient must perform include following all the recommendations of a specialist, timely taking tests to study the pathological condition in dynamics and observing the prescribed daily regimen, diet and medications.

How to donate blood for lipase correctly

The accuracy of the result obtained depends on all the conditions observed for the preparation and sampling of biomaterial. The test is carried out only in the morning hours - until 11 am, after which time the level of the enzyme decreases. At least 12 hours should pass from the last meal, in the last couple of days before delivery, you must not eat fried and fatty foods, consume alcohol, smoked meats and spicy foods. It is also not advisable to eat spicy food, and on the day of the analysis, you can not drink anything other than pure unsweetened and still water. Even tea and coffee can skew the correct blood counts.

On the day of blood donation, you must not smoke less than an hour before the test. It is not advisable to experience physical and emotional stress. If the patient is taking any medications, then the possibility of taking them before donating blood should be discussed with the attending physician. In no case should the medication be canceled on your own. Just before donating blood, you need to sit quietly and bring yourself into a calm state.

Lipaza - what is it? The human body contains enzymes that are vital. They ensure the normal process of food digestion, promote the release of essential vitamins, amino acids and minerals. All this is necessary not only for good health, without these substances a person could not live. One of these enzymes is lipase.

1 Description of the indicator

The peculiarity of enzymes is that they serve as catalysts that can stimulate the appearance of the interaction of the necessary substances and support it. But at the same time, the enzymes themselves, which are synthesized by the body, are not consumed. In the same way, an enzyme such as lipase is synthesized, which dissolves in water. Lipase is a combination of protein molecules that affects insoluble esters, stimulates their catalytic process, breaks down and normalizes the digestion of neutral fats, their dissolution and fractionation.

Lipase is not alone in aiding the process of digesting fat, and works in conjunction with bile. Together with fats, lipase breaks down and digests fatty acids. In addition, the enzyme takes part in the process of processing such fat-soluble vitamins as A, E, D and K into heat. Together with heat, the body also receives energy.

Lipase has the ability to affect lipids, as a result of which they dissolve. Because of this, fatty acids directly enter the tissues of internal organs and systems.

2 Enzyme production

The enzyme in question is produced not by one organ, but by several, since a lot of it is needed. In order to insure a person, nature has endowed him with a structure in which enzymes produce several organs at once, namely:

• pancreas;
• lungs;
• liver;
• intestines.

In newborns, this enzyme is produced in the mouth. This is due to the presence of special glands. As a result, the process of lingual lipase synthesis is observed in infants, which is necessary for influencing milk fats.

Lipase- a water-soluble enzyme synthesized by the human body that catalyzes the hydrolysis of insoluble esters (lipid substrates) and promotes the digestion, dissolution and fractionation of neutral fats.

Together with bile, lipase stimulates the digestion of fats, fatty acids, fat-soluble vitamins A, E, D, K, transforming them into energy and heat.

The purpose of lipoprotein lipase is to break down triglycerides (lipids) in blood lipoproteins, thereby ensuring the delivery of fatty acids to tissues.

Lipase is produced by:

• pancreas;
• liver;
• lungs;
• intestines
• special glands located in the mouth of infants.

In the latter case, the so-called lingual lipase is synthesized. Each of the listed enzymes promotes the breakdown of a specific group of fats.

Lipase functions in the body

The main function of any type of lipase is the processing of fats, their splitting and fractionation. In addition, this enzyme is involved in energy metabolism, the processes of assimilation of polyunsaturated fatty acids and some vitamins.

The most important enzyme that ensures complete and timely assimilation of lipids is pancreatic lipase (produced by the pancreas). The enzyme enters the digestive tract in the form of an inactive enzyme - prolipase, where it is transformed into an active form under the influence of colipase (another pancreatic enzyme) and bile acids. Pancreatic lipase breaks down fats emulsified by hepatic bile. It is a catalyst for the breakdown of triglycerides (neutral fats) contained in foods into higher fatty acids and glycerin.

• Hepatic lipase promotes the absorption of chylomicrons and low density lipoproteins, and also regulates the content of plasma lipids.
• Gastric lipase stimulates the breakdown of oil tributyrin.
• Lingual variety lipases breaks down the fats in breast milk.

There are certain criteria for the rate of lipase in the blood.

• For adults, both female and male (over 17 years old), the indicator ranges from 0 to 190 units per 1 milliliter of blood.
• In children and adolescents under 17 years of age, lipase levels in the range from 0 to 130 units per milliliter are considered the norm.
• With regard to pancreatic lipase specifically, the content of 13-60 units of pancreatic enzyme per 1 ml of blood is considered normal.

What does an increase in blood lipase levels indicate?

From the point of view of significance, lipase produced by the pancreas plays an important role in the diagnosis. Fluctuations of its level in the composition of blood serum in one direction or another are an indicator of the presence of certain disorders in the work of the pancreas.

An increase in the level of the enzyme is noted when:

• pancreatitis, proceeding in an acute form, or with an exacerbation of a chronic process;
• biliary colic;
• trauma to the pancreas;
• the presence of neoplasms in the pancreas;
• chronic pathologies of the gallbladder;
• the formation of a cyst or pseudocyst in the pancreas;
• blockage of the pancreatic duct with a scar or stone;
• intrahepatic cholestasis;
• acute intestinal obstruction;
• intestinal infarction;
• peritonitis;
• perforation of a stomach ulcer;
• perforation of the internal (hollow) organ;
• acute or chronic renal pathology;
• mumps, in which the pancreas is damaged;
• metabolic disorders that occur in diabetes mellitus, obesity or gout;
• cirrhosis of the liver;
• long-term use of medications - in particular, barbiturates, narcotic analgesics, heparin, indomethacin;
• organ transplant operations.

In rare cases, the process of lipase activation is associated with some injuries - for example, fractures of tubular bones. But in this case, fluctuations in the level of the enzyme in the blood cannot be considered a specific indicator of the presence of physical damage. For this reason, lipase tests are not considered when diagnosing injuries of various origins.

Determination of the serum lipase level is of particular importance in any lesion of the pancreas. In this case, a blood test for the content of this enzyme, together with an analysis for amylase (an enzyme that promotes the breakdown of starch into oligosaccharides), with a high degree of reliability indicates the presence of a pathological process in the tissues of the pancreas: both indicators are higher than normal). In the process of normalization of the patient's condition, these enzymes do not return to adequate indicators at the same time: as a rule, the lipase level remains at a high level longer than the amylase level.

In the course of research, it was found that with pancreatitis on the first day, the lipase level rises only to moderate levels and in very rare cases reaches a level at which a diagnosis can be made with a high degree of confidence. Basically, the presence of the disease on the basis of lipase activity indicators can be determined only on the third day. In this case, some points should be taken into account:

• with an edematous variety of the disease, the lipase level remains within the normal range;
• an average increase in the level of the enzyme is noted in the presence of fatty pancreatic necrosis;
• lipase activity increases 3.5 times in hemorrhagic pancreatic necrosis.

A high level of lipase persists from 3 to 7 days from the onset of the development of inflammation. The downward trend is recorded only after 7-14 days.

With an increase in the lipase level by 10 or more times, the prognosis of the disease is considered extremely unfavorable, especially if the activity persists for several days and does not fall below three times the normal value.

An increase in the level of pancreatic lipase has its own specifics, depending on the specific cause that caused it:

1. In the acute form of pancreatitis, the level of the enzyme begins to rise several hours (from 2 to 6) after the defeat of the pancreas. After 12-30 hours, it reaches its maximum level and begins to decline. The normalization of enzyme activity is observed after 2-4 days.
2. In the chronic form of pancreatitis, a moderate increase in lipase levels is first recorded. But as the pathology develops, the indicator returns to normal.

Causes of low serum lipase levels

Low lipase levels are recorded:

• in the presence of a malignant neoplasm in any part of the body, except for the pancreas itself;
• due to a decrease in the function of the pancreas;
• with cystic fibrosis (cystic fibrosis) - a genetic disease with a severe course resulting from pathological damage to the glands of external secretion (gastrointestinal tract, lungs).
• after surgery to remove the pancreas;
• with an excess content of triglycerides in the blood, which occurs due to malnutrition with an abundance of fatty foods in the diet or due to hereditary hyperlipidemia.

In some cases, a decrease in lipase levels is a marker of the transition of pancreatitis to a chronic form.