Liver and pancreas
Lipase
A digestive enzyme from the pancreas; strongly raised in acute inflammation of the pancreas (pancreatitis).
Everything about this testWhat it measures
Lipase is an enzyme that the pancreas makes to digest fat from food. It travels through the pancreatic duct to the bowel. Normally only a little lipase enters the blood. If the pancreas becomes inflamed or damaged, or the duct is blocked, lipase enters the blood and the value rises, in an acute inflammation within 24 to 48 hours.
- Acute inflammation of the pancreas (acute pancreatitis), usually due to gallstones or alcohol
- Blockage of the pancreatic duct, for example by a gallstone
- A slightly raised value in other abdominal conditions, such as a stomach ulcer or bowel obstruction, or with reduced kidney function
High
A slightly raised lipase, less than three times the upper limit, often has a cause other than the pancreas: reduced kidney function, a stomach ulcer, a bowel obstruction or another abdominal condition. Some medicines can also raise the value slightly. In people without symptoms, a slightly raised value often cannot be explained and has no consequences. A value of more than three times the upper limit, together with sudden severe pain in the upper abdomen that can spread to the back, fits acute inflammation of the pancreas; nausea, vomiting and fever also go with it. The most common causes of this are gallstones and alcohol.
Low
A low lipase has no meaning in healthy people. In long-lasting (chronic) inflammation of the pancreas or cystic fibrosis, the pancreas can become so damaged that it makes less lipase. A low value in the blood is not a reliable test for this; pancreatic function is then tested with elastase in the stool.
If your result is abnormal
With a strongly raised lipase and severe abdominal pain, assessment the same day is needed; usually hospital admission and an abdominal ultrasound to look for gallstones follow. With a slightly raised value without symptoms, the GP repeats the measurement and looks at kidney function, medicines and alcohol use.
Reliability
With acute abdominal pain, lipase is the best blood test for acute inflammation of the pancreas and more reliable than amylase, because lipase is more specific to the pancreas and stays raised longer. According to the international definition, it is the combination of abdominal pain and a lipase or amylase raised more than three times; a raised value without symptoms is not inflammation of the pancreas. A slightly raised value is not very specific, and the level of the value says little about the severity of the inflammation.
Limitations
- Reduced kidney function raises lipase, because the enzyme is excreted less well.
- Some medicines can raise lipase, including drugs for diabetes and overweight such as semaglutide and liraglutide.
- After acute inflammation of the pancreas, lipase stays raised for about 5 to 7 days; after that the value can be normal again.
- Measuring methods and reference values differ by laboratory.
How common is this
In 2005, acute inflammation of the pancreas occurred in about 1 in 6,800 people in the Netherlands. About 60 in 100 cases are due to gallstones and 20 in 100 to alcohol; in about 10 in 100 the cause is unknown. A slightly raised lipase without symptoms is more common, but how common is not well known.
Who is this useful for
Useful for following up an earlier raised value, after a past inflammation of the pancreas on the advice of the treating doctor, and as an addition to testing by the GP with symptoms in the upper abdomen that may fit the pancreas. With sudden severe abdominal pain, a test by post is not suitable, because assessment by a doctor is needed straight away. In healthy adults without symptoms, lipase adds little.
Downsides and risks
- A slightly raised lipase without symptoms often has no meaning, but can lead to unnecessary worry and unnecessary imaging.
- A test by post only gives a result after a few days; with acute severe abdominal pain, that can wrongly lead to delayed care.
Sources
Always discuss an abnormal result with your GP. If a result is strongly abnormal, we try to reach you as soon as possible. Read your result yourself as well and contact your GP if in doubt. A test does not make a diagnosis. Read more about risks and results