Lipase is an enzyme secreted by the pancreas which is an important organ of the digestive system. After production the enzyme passes into the small intestine where it performs a variety of important digestive processes. It helps breakdown fats and transport dietary lipids like fats, triglycerides, and oils. Fats are a main energy source for the heart and muscles, thereby making lipase a very important component. Lipase breaks down dietary fats and complex triglycerides into monoglycerides, glycerol, and free fatty acids, which then easily mix into the blood. Lipase is produced only by the pancreas; hence, abnormal lipase levels is a sign of some underlying pancreatic condition.
The HPL or human pancreatic lipase is one of the major lipases present in the digestive system of humans. Other vital lipases include endothelial lipase, hepatic lipase/HL, and lipoprotein lipase.
When are lipase tests carried out?
After it is produced by the pancreas, lipase moves into the small intestine and then helps breakdown fats. Another enzyme called amylase assists lipase in this fats breakdown process. However, amylase is also produced by saliva and other glands, while lipase is solely produced by the pancreas. Hence, lipase tests are performed to check the functioning of the pancreas.
Pancreatic diseases are often accompanied by symptoms such as fever, pain in abdomen, loss of appetite, and nausea, etc. Hence, patients who elicit the above listed symptoms need to undergo lipase tests to check for pancreas problems. Such patients may also asked to undergo additional tests to check for the presence of disorders like celiac disease, cystic fibrosis, and Crohn’s disease, etc.
The Lipase test
In adults, lipase tests are conducted by examination of a blood sample drawn from a vein in the arm. Patients need to undergo fasting for nearly 8 hours or more before the test. Also, intake of certain drugs like cholinergic medicines, bethanechol, codeine, indomethacin, methacholine, meperidine, and morphine, etc., should be stopped a few days before the lipase test is carried out as these drugs can affect the test results and interpretation. Dialysis can also affect lipase test results. Hence, lipase tests are normally done before a patient has dialysis.
The lipase test assists in determining and monitoring inflammation or infection of the pancreas, i.e., acute pancreatitis, as well as chronic pancreatitis and other pancreatic disorders. Doctors may also recommend lipase tests to check for the presence of other conditions like celiac disease, cystic fibrosis, etc. The test may also be conducted periodically to verify the efficiency and effectiveness of the treatment given for an underlying case of pancreatitis.
Doctors may also check the levels of amylase along with lipase levels during the test. The levels of both lipase and amylase tend to rise considerably when affected by acute pancreatitis. Checking the levels of pancreatic lipase is considered as the best method to determine and diagnose problems of the pancreas.
Lipase – normal range
The reference scales used for measuring normal lipase range levels differ from one country to another and from one lab to another, as per their individual specifications. In some labs, the normal lipase range falls between 5 to 70 units/L, while measurements between 0 to 160 units/L are considered as within the normal range in other laboratories. Such variation in the normal lipase range reference scale can greatly affect the manner in which the test results are interpreted. Hence, it is best to leave it to the doctors to interpret the results and arrive at a diagnosis.
If the lipase readings are five to nine times more than the upper normal lipase levels limit, then it can be said with surety that the patient is suffering from a case of acute pancreatitis. Lipase levels are also significantly elevated when a person is affected by pancreatic duct blockages, pancreatic cancer, or other pancreatic diseases. Similarly, peptic ulcers, inflammation of the salivary glands, and bowel blockages also tend to increase the levels of lipase enzyme. When the lipase levels are nearly double as compared to the normal range, then it can a sign of some underlying kidney problem.
Low levels of lipase
- Lower than normal range lipase levels can be seen when an individual is on saline drips or infusion.
- Low lipase enzyme levels are also indicative that the pancreas cells that produce lipase are permanently damaged. Such cases are usually found in individuals with prolonged conditions that severely affect the pancreas, such as celiac disease, cystic fibrosis, or Crohn’s disease.
- Low levels of lipase can cause indigestion. Hence, people who experience indigestion on a frequent basis need to go for lipase tests. Lipase supplements help manage and overcome the adverse effects of low lipase enzyme levels.
High levels of lipase
- When the lipase levels are within the normal range, then the health of the digestive system is maintained. People with acute pancreatitis tend to have lipase levels that are 5 to 10 times the normal range. The rise in enzyme levels occur in a day or two after an attack of acute pancreatitis; the levels remain above the normal range for nearly 7 to 8 days and then gradually lower to the normalcy.
- High lipase enzyme levels are common in alcoholics. Use of medications like morphine, indomethacin, and codeine can also raise lipase levels. Other conditions that are indicative of elevated lipase levels include stomach ulcers, pancreatic cancer, gastroenteritis, or pancreatic duct obstructions, digestive tract blockages, and other diseases of the pancreas.
- High lipase enzyme levels are usually accompanied by symptoms like sweating, pain in abdomen, nausea, weakness, and vomiting, etc. Some people may not exhibit any visible symptoms of elevated lipase levels.
- Acute pancreatitis and associated elevated lipase levels can be managed and treated with medications and adhering to a pancreatitis diet plan. In most cases, the condition is cured in about 15 days. Improper care can trigger a relapse. In case of recurring acute pancreatitis, or if damage caused by acute pancreatitis cannot be effectively repaired, then patients are most likely to develop chronic pancreatitis.
Quitting smoking and alcohol abuse; drinking lots of water; eating a low-fat, low-cholesterol balanced diet; intake of easily digestible fiber-rich foods; and an active lifestyle can help prevent pancreas problems and abnormal lipase enzyme levels.