Pancreatic lipase: what is it? Lipase in the blood: norm and causes of deviations Lipase where it is produced under what conditions
What are lipases and what is their connection with fats? What is hidden behind too high or too low levels of these enzymes? Let's analyze what levels are considered normal and why they may change.
What is lipase – definition and types
Lipases are enzymes, i.e. squirrels, which perform one very precise task: accelerate the breakdown of triglycerides (fats), from which glycerol and fatty acids are released.
Lipases are produced in our body and act throughout the digestive tract: mouth, stomach, intestines, as well as in the liver, in the blood, in specialized cells (adipocytes, which store fat) and cellular organelles (lysosomes).
There are several types of lipase, which are classified depending on their location and purpose of action.
Let's look at the main ones:
- lingual lipase and salivary lipase: begins the breakdown of fats from the very first moments of digestion, i.e. in the oral cavity.
- gastric lipase: present in gastric juice, where the environment is very acidic. In an adult, it breaks down up to 30% of triglycerides obtained from food, because pancreatic lipase does most of the work in the next step. In newborns, on the contrary, gastric and lingual lipases are particularly active, since the pancreas is not yet active enough.
- pancreatic lipase: The pancreas is the main producer of lipase. This enzyme from the pancreatic juice enters the duodenum, where it forms fatty acids that are easily absorbed by the intestinal walls. The pancreas also produces colipase, another protein that binds other lipases and makes them more effective.
- hormone-sensitive lipase: It is the enzyme responsible for lipolysis, i.e. breaking down fats in adipose tissue cells (this lipase is found right inside adipocytes) to mobilize these reserves for energy. The name of the enzyme reflects its close dependence on hormones such as epinephrine and norepinephrine, which activate it, and insulin, which inhibits the action of lipase to promote triglyceride formation and fat storage.
- lipoprotein lipase: located at the level of the capillary walls and also reacts to the presence of certain hormones. The name is due to the specific action of the enzyme on triglycerides transported into the blood.
There are two forms of lipoprotein lipase:
- Adipose tissue lipoprotein lipase: activated by insulin, breaks down triglycerides into fatty acids, which accumulate in adipocytes (that is, the action is almost opposite to hormone-sensitive lipase).
- Lipoprotein lipase of skeletal muscle and heart tissues: activated by glucagon and adrenaline (and inhibited by insulin), affects the hydrolysis of LDL triglycerides for energy.
- liver lipase: Produced by the liver and fuels LDL regeneration.
- lysosomal lipase: Also called acid lipase, it is found in cell organelles that digest various molecules, including triglycerides and cholesterol.
Concentration of hydrolytic enzymes
Hydrolytic enzymes, that is, lipases, which are formed at the level of the pancreas, constantly circulate in the blood, this allows you to control the level of lipase concentration through venous blood analysis.
Lipase level is not included in the “routine” tests, but the study is carried out if pancreatitis is suspected (or other pathologies that may include the pancreas), in combination with symptoms such as nausea, acute abdominal pain, loss of appetite.
Reference values Blood lipase concentrations vary from laboratory to laboratory, but the guideline is:
- up to 50 years – 5-58 IU/l
- over 50 years old – 5-67 IU/l
High lipase levels - reasons
Values slightly above normal may be associated with:
- inflammation of the salivary glands, which leads to increased secretion of the enzyme;
- intestinal ulcers, especially at the level of the duodenum, since the enzyme is most active in this area;
- celiac disease, due to intestinal malabsorption problems associated with gluten intolerance, or more general malabsorption phenomena (for example, pernicious anemia in the case of impaired absorption of vitamin B12);
- renal failure, which impairs the excretion of the enzyme;
- for cholecystitis, since the formation of gallstones or inflammation of the gall bladder can interfere with the passage of bile and pancreatic juices, which leads to inflammation of the pancreas;
- use of certain medications, For example, anti-inflammatory and diuretics, which change cell permeability by stimulating the release of lipase.
If concentrations are increased significantly (two to five times relative to the norm), suspicion arises of:
- acute pancreatitis: If the blood lipase level increases within an hour after an attack of severe abdominal pain, and persists for about 4 days or more; in addition, in acute pancreatitis, high lipase levels are associated with high amylase levels;
- other problems related to the pancreas(rarely cancer). When the pancreas is damaged or inflamed, the organ becomes more permeable and therefore large amounts of lipase can leak and enter the bloodstream.
Reduced level of lipase in the blood - causes
A decrease in the concentration of lipase in the blood is observed in the following cases:
- chronic pancreatitis: amylase and lipase levels decrease due to damage to pancreatic cells, which lose the ability to produce enzymes;
- diabetes mellitus, since the action of lipases is closely related to the concentration of insulin in the blood;
- Crohn's disease, in which the activity of the enzyme in the intestines is seriously affected due to chronic inflammation of the organ;
- cystic fibrosis, due to impaired pancreatic function.
Very low levels of lipase are often combined with high levels cholesterol and triglycerides in the blood, high blood pressure, varicose veins and difficulty losing weight.
Altered lipase levels - what to do
When lipase levels are too high or too low, your doctor will order additional tests to determine the specific cause of this change (pancreatitis, kidney failure, etc.).
However, there are behaviors that we can follow for preventive purposes that help normalize lipase concentration values.
In case of high lipase levels
In addition to drug therapy prescribed by a doctor, if pancreatitis, cholecystitis, etc. is diagnosed, changing some eating habits will be very useful.
Here are some examples:
- completely stop drinking alcoholic beverages which harm the pancreas and liver;
- a high level of lipase “informs” us about a violation in the digestion of fats, so switching to a diet will be useful, rich in fiber;
- drink a lot of water(a good practice is 8-10 glasses per day) because lipase is a hydro-soluble enzyme and requires dilution.
In case of low lipase levels
What to do when blood lipase levels are too low?
- practice physical exercise: Regular physical activity is a really good habit! Research shows that physical activity helps lower blood triglyceride levels and also has a positive effect on cholesterol levels;
- use nutritional supplements: You can find lipase supplements commercially available in both animal and plant sources. Most often, these supplements are a mixture of several enzymes (lipase + amylase + pectin + ...) to facilitate digestion;
- As with high lipase levels, food style is of great importance. Low lipase levels make it more difficult to digest fats, so you need to reduce your fat intake (ideally no more than 20g per day)! A diet rich in fruits, vegetables and grains, as well as low-fat yoghurts and cheeses, is a great solution!
Doctors pay great attention to blood tests for a reason. If not all, then most of the known pathologies are reflected in the blood in one way or another. Today we will talk about diseases of the pancreas, which can be detected using an enzyme called lipase, the increase or decrease of which indicates that the digestion process is not going according to plan.
Before explaining the role of lipase as an enzyme, it is important to explain what “enzymes” are and why they are needed. An enzyme (synonym: enzyme) is a special molecule that breaks down a chemical compound into simpler components. There are a large variety of enzymes, and each of them is responsible for a specific molecule that needs to be broken down. They look like recesses for molecules: for example, if water looks like a square and two circles (1 hydrogen molecule and 2 oxygen molecules), then the enzyme that breaks it down will look like a recess for one square and two circles. This explains why a certain enzyme can only break down one type of molecule: others are not physically suitable for its shape.
Lipase is common name for a group of enzymes(we will consider individual types in the next subsection). Functions of lipase: breakdown of fats, phosphorus compounds and some vitamins. Lipase is produced by many tissues of the body, but the main share is produced by the pancreas. Behind it in the “rating” is the liver, after the liver: lungs, saliva, intestines. Blood lipase level: from 0 to 190 units/liter.
Types of lipase
Lipase is divided into:
- Lipoprotein lipase. This type is produced by many tissues, the highest concentrations can be found in the heart, muscle and adipose tissue. Lipoprotein lipase breaks down lipids (fats) circulating in the blood. If this type of lipase is lacking, the patient is at increased risk of atherosclerosis because undigested fat settles on the inner walls of blood vessels.
- Pancreatic lipase. This enzyme is the main one among lipases; it is produced by the pancreas and enters the intestines, where it breaks down fats. Pancreatic diseases lead to increased production of the enzyme, and it begins to enter the blood, which is reflected in the tests.
- Liver lipase. This lipase is almost identical in its action to pancreatic lipase, but it does not enter the intestines, but directly into the blood. Together with lipoprotein lipase, they break down fats circulating in the bloodstream.
- Phospholipase. This type destroys fats that contain phosphorus. Phospholipase is extremely necessary for the body, because phosphorus supplied with food is converted into ATP - a molecule that stores energy and delivers it to other cells. Phospholipase is divided into several types (A1, A2, B, C, D), but only those who are well acquainted with biological chemistry will understand the difference between them.
Is there a possibility of error in the research?
Unlikely, but possible.
Reasons:
- Eating fatty foods before taking the test. If you eat something fatty, lipase in the blood will rush to the incoming fats and begin to break them down, which will reduce its concentration.
- Fractures of tubular bones. When fractures occur, the enzyme contained in these bones is released into the blood, which causes an unreasonably increased rate.
Increased values
Lipase is elevated when a liter of blood is found more than 190 units. In the vast majority of cases, this happens for one of two reasons: either the pancreas produces more lipase than necessary, or the body does not have time to utilize the excess.
Possible reasons:
- acute or chronic pancreatitis;
- malignant tumor or cyst in the pancreas;
- intestinal obstruction;
- peritonitis;
- bone fractures, soft tissue injuries;
- renal failure;
- obesity, diabetes mellitus;
- taking barbiturates.
To bring lipase levels back to normal, you need to eliminate the root causes of its increase. This needs to be done as quickly as possible, since all causes (except obesity, soft tissue trauma and chronic pancreatitis) threaten the health and life of the patient here and now. Treatment methods depend on the specific pathology; the doctor must choose a treatment regimen.
Lipase is a substance produced by the human body that promotes the fractionation, digestion and breakdown of neutral lipids. Together with bile, a water-soluble enzyme triggers the digestion of fatty acids, fat, vitamins A, D, K, E, converting them into heat and energy.
The substance takes part in the breakdown of triglycerides in the bloodstream, thanks to this process the transport of fatty acids to cells is ensured. The pancreas, intestines, lungs, and liver are responsible for the secretion of pancreatic lipase.
In young children, the enzyme is also produced by a number of special glands, their localization in the oral cavity. Any of the pancreatic substances is designed to digest certain groups of fats. Pancreatic lipase in the bloodstream is an accurate marker of the onset of the development of an acute inflammatory process in the organ.
Functions of lipase
The main function of lipase is fat processing, breakdown and fractionation. In addition, the substance takes part in the absorption of a number of vitamins, polyunsaturated fatty acids, and energy metabolism.
The most valuable substance that ensures complete and timely absorption of fats is pancreatic lipase produced by the pancreas. It enters the digestive system in the form of prolipase, an inactive enzyme; the substance is activated by another pancreatic enzyme, colipase, and bile acids.
Pancreatic lipase breaks down lipids emulsified by hepatic bile, which accelerates the breakdown of neutral fats found in foods into glycerol and higher fatty acids. Thanks to hepatic lipase, low-density lipoproteins and chylomicrons are absorbed, and the concentration of fats in the blood plasma is regulated.
Gastric lipase stimulates the breakdown of tributyrin, and the lingual version of the substance breaks down lipids found in breast milk.
There are certain criteria for the content of lipase in the body; for adult men and women, the normal value will be 0-190 IU/ml, for children under the age of 17 years – 0-130 IU/ml.
Pancreatic lipase should contain about 13-60 U/ml.
What does increased lipase mean?
Sugar level
If pancreatic lipase increases, this is important information when making a diagnosis and becomes an indicator of the development of certain disorders in the pancreas.
Severe diseases can increase the concentration of the substance, including acute pancreatitis, biliary colic, malignant and benign neoplasms, pancreatic injuries, and chronic gallbladder diseases.
Often, an increase in lipase indicates cysts and pseudocysts in the pancreas, blockage of the pancreatic duct with stones, scar, or intracranial cholestasis. The causes of the pathological condition will be acute intestinal obstruction, peritonitis, acute and chronic renal failure, perforation of a stomach ulcer.
In addition, an increase in lipase becomes a manifestation of:
- perforation of a hollow organ;
- metabolic disorders;
- obesity;
- any ;
- mumps with damage to the pancreas;
- gouty arthritis;
- transplantation of internal organs.
The problem sometimes develops with prolonged use of certain medications: barbiturates, narcotic analgesics, Heparin, Indomethacin.
It is possible that the activation of pancreatic lipase is caused by injuries, fractures of tubular bones. However, various fluctuations in the parameters of the enzyme substance in the bloodstream cannot be considered a specific indicator of damage.
Thus, a lipase test is almost never prescribed when diagnosing injuries of various etiologies.
In what diseases does lipase increase?
Testing lipase levels in the blood becomes important for various lesions of pancreatic tissue. Then the analysis for this enzyme is recommended to be carried out together with determining the amount of amylase, an enzyme that promotes the breakdown of starchy substances into oligosaccharides. If both indicators are significantly exceeded, this indicates the development of a severe pathological process in the pancreas.
During therapy and normalization of the patient’s condition, amylase and lipase do not reach adequate levels at the same time; lipase often remains elevated much longer than amylase.
Laboratory studies have shown that during the inflammatory process in the pancreas:
- lipase concentration increases only to moderate levels;
- indicators extremely rarely reach a level where the doctor can make an accurate diagnosis without a doubt;
- the disease can be diagnosed only on the third day.
It will be necessary to take into account that with severe swelling the level of the substance remains normal, the average enzyme level is observed in the presence of fatty pancreatic necrosis. The degree of lipase activity increases approximately threefold in the hemorrhagic form of pancreatic necrosis.
High lipase persists for 3-7 days from the onset of acute inflammation; a tendency towards normalization of the substance is observed only on days 7-14 of the pathological condition. When the pancreatic enzyme has risen to 10 or higher, the prognosis of the disease is considered to be unfavorable, especially if blood biochemistry has shown that the activity persists for several days and does not fall to three times the norm.
The rapid increase in pancreatic lipase levels has a specificity that is closely related to the cause of the disorder. characterized by an increase in the enzyme 2-6 hours after an exacerbation; after 12-30 hours, lipase reaches peak levels and gradually begins to decline. After 2-4 days, the activity of the substance reaches normal levels.
In the chronic course of the disease, initially there is a slight increase in lipase; as the disease develops and enters the remission phase, it normalizes.
Causes of low lipase levels
The development of malignant neoplasms in any part of the body, not only pathology of the pancreas, can reduce the concentration of lipase. Also, the reasons should be sought in decreased pancreatic function, a genetic disorder with an extremely severe course that occurs due to damage to the exocrine glands (cystic fibrosis).
After surgical treatment to remove the pancreas, with excessive triglycerides in the bloodstream, which was caused by an unhealthy diet with an abundance of fatty foods, hereditary hyperlipidemia, the level of pancreatic enzyme also decreases. Often, a decrease in lipase levels is observed during the transition of pancreatitis from an acute form to a chronic form.
The complete absence of pancreatic lipase occurs with congenital deficiency of its production.
What enzymes the pancreas secretes are described in the video in this article.
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 level practically does not differ in the blood of women and men. Lipase, its normal level in the blood should be in what volumes? When should you get tested - what symptoms should prompt you to do so?
Lipase - what is it and what does it do?
It is a liquid-soluble protein compound that is produced by certain groups of human internal organs. She is responsible for a variety of actions:
- Separation, breakdown and processing of fats;
- Absorption of certain fatty acids and vitamins;
- The work of energy metabolism.
In addition, the place where the enzyme is produced imposes its own differences, therefore the function of the enzyme differs somewhat depending on its localization:
- The highest concentration of lipase is located in the blood; its norm is much higher than in other organ systems. It ends up in the pancreas in a passive form, but when it reacts with the enzymes present there, it becomes active. This work of lipase is pancreatic and performs the most important work there, promoting the decomposition of complex fats into simple substances.
- In the liver, lipase regulates the level of plasma lipids and also helps metabolize lipoproteins and chylomicrons. This function of lipase is called hepatic.
- In the stomach, lipase performs the function of breaking down fats, being a gastric lipase.
- Newborns have their own lipase, called lingual lipase. It is located in the baby’s mouth and helps break down the enzymes that come with milk.
- Lipase is also found in the lungs, but in small quantities.
Normal Lipase Values
The amount of lipase in the blood can only be determined by taking a lipase blood test. Its normal amount does not change depending on the gender of the patient; only the person’s age matters. From the moment of birth until the age of 18, the child should have a concentration of up to 131 units/ml. After a person turns 18 years old, the amount of lipase in the blood increases slightly and can reach 191 units/ml.
If the patient does not have pathologies of the stomach or other digestive organs, then the indicators of digestive enzymes change only in minimal amounts. If the gastrointestinal tract is damaged, then parts of the diseased organ are gradually broken down and a large release of an enzyme that breaks down fat cells into the blood is provoked. This often happens not only with injuries, but also with exacerbations of diseases such as pancreatitis, gastric ulcers and other similar diseases.
When should you 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 primarily in case of malfunctions of the digestive tract or the following problems:
- Any form of pancreatitis;
- Mumps, threatening infertility;
- Tumor formations in the gastrointestinal tract;
- Pathologies of the gallbladder and other serious disorders in the functioning of the gastrointestinal 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 increased lipase
For what reasons can the norm be exceeded?
A lipase level that is higher than normal indicates the presence in the body of inflammatory processes in the organs of the digestive system, which occur in acute forms of diseases and infections in the pancreas in the first place. Also, diseases leading to an increase in the enzyme include:
- Exacerbation of a patient’s chronic pancreatic disease or 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;
- Problems with intestinal obstruction;
- Incomplete functioning of one or both kidneys;
- Colic formed in the gall bladder;
- 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 medications taken both under the supervision of a doctor and by him. These include any analgesic drugs, indomethacin and heparins. In this case, a decrease in concentration can be achieved by simply stopping taking the drugs.
Also, an increase in the concentration of lipase in the blood can be affected by fractures of long bones, since they contain a large amount of fat. Such formation is dangerous to health, as it can trigger the onset of fat 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. Elevated lipase levels are usually diagnosed for up to 14 days, after which they gradually decrease. Exceeding this indicator for longer than two weeks is considered an unfavorable factor.
Why might there be a reduced rate?
Lipase levels below normal may also indicate disruption of the gastrointestinal tract and dangerous pathologies of the whole body. Such abnormalities include a cancerous tumor of any location and size, a 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 appears at the moment of transition of the disease from the acute phase to the chronic form. Only a doctor can confirm or refute the presence of pathology, the transition from one stage to another, and establish the correct diagnosis based on blood tests, ultrasound and other necessary studies.
The tasks that the patient must perform include following all the specialist’s recommendations, taking timely tests to study the pathological condition over time, and following the prescribed daily regimen, diet and medications.
How to donate blood for lipase
The accuracy of the result obtained depends on all conditions observed for the preparation and collection of biomaterial. The analysis is carried out only in the morning - until 11 am, after this time the enzyme level decreases. At least 12 hours must pass since the last meal; in the last couple of days before delivery, you should not eat fried and fatty foods, drink alcohol, smoked meats and spicy foods. It is also not advisable to eat spicy food, and on the day of the test you should not drink anything other than clean, unsweetened and still water. Even tea and coffee can distort the correct blood counts.
On the day of donating blood, you should 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, the possibility of taking them before donating blood should be discussed with the attending physician. Under no circumstances should you stop taking medications on your own. Immediately before donating blood, you need to sit quietly and put yourself in a calm state.
Lipase is a special enzyme responsible for the decomposition into components and processing of fats in the human digestive system. The substance is produced by the pancreas, intestines, liver and lungs. The substance is also produced in the baby’s mouth - this is the lingual type. The enzyme performs important functions: it actively participates in energy metabolism, helps to absorb vitamins and polyunsaturated fatty acids. Of particular interest is pancreatic lipase, secreted by the pancreas.
Types of lipase and its level in the blood
The concentration of the substance in the blood of a healthy person is almost unchanged. In children and adolescents from birth until the age of 17, the level of the substance in 1 ml of blood is determined from 0 to 130 units. In an adult, normal values range from 0 to 190 units per 1 ml. The indicators are identical for both sexes. The level of lipase is determined based on the results of a laboratory blood test.
The concentration of lipase in chronic and acute pancreatitis differs from the norm, so an analysis of the level of this substance in the blood is mandatory when diagnosing pancreatic diseases. An increase in enzyme levels indicates a developing inflammatory process in the pancreas.
Before taking the test, you must first properly prepare: you should refrain from eating fatty, peppery, and salty foods for about 12 hours. The analysis is performed on an empty stomach, and venous blood is taken.
Indications for testing
Gastroenterologists will need the results of a study of the amount of enzyme in the blood when diagnosing the following pathologies:
- Acute phase of pancreatitis. The most informative is a blood test, which was taken three days after the attack; during this period, in acute pancreatitis, lipase will reach its highest concentration.
- Chronic phase of pancreatitis. The prolonged course of inflammation in the pancreas deprives it of the ability to produce enzymes, so the indicators of the substance are poorly expressed.
- Mumps disease. An insidious disease that provokes damage to other organs in patients.
Causes of elevated lipase levels
The level of pancreatic lipase differs from the norm and increases in various diseases of the gastrointestinal tract. The use of certain medications (for example, barbiturates, analgesic drugs) can also increase the content of the substance in the body. In addition, the enzyme in the blood increases after severe injuries to tubular bone tissue.
Diseases in which the rate increases
Pancreatic lipase increases in the following situations:
- pancreatitis in the acute phase;
- chronic form of pancreatitis;
- pancreatic cyst;
- intestinal infarction;
- intestinal obstruction;
- peritonitis;
- diabetes mellitus of any type;
- obesity;
- intrahepatic cholestasis;
- perforation of the genital organs.
It is necessary to take into account the features of the pancreatic lipase indicator. On the first day of exacerbation of pancreatitis, the concentration of the substance increases slightly, the maximum increase is observed after three days. If inflammation of the pancreas leads to the occurrence of edema, then the level does not exceed the normal range; with hemorrhagic pancreatic necrosis, the concentration of the enzyme will be increased threefold or even more times.
In the chronic form of the disease, the enzyme initially increases slightly, then returns to the normal range.
Causes of Low Lipase Levels
The cause of low lipase levels is usually the presence of cancer, but not in the pancreas. In addition, the concentration of the substance decreases with an unbalanced diet, when the menu consists mainly of fats. A decrease is also observed in hereditary pathology - hyperlipidemia, when a high level of lipids is determined in the body. The level of pancreatic lipase in the blood declines if acute pancreatitis becomes chronic.
It should be understood that it is impossible to make a reliable diagnosis based on a blood test alone, so the doctor, as a rule, prescribes additional research methods.
