Parameter
| Biomarker | Lipase | Full name | Lipase | Molecular Type | Proteins (hydrolases, mainly pancreatic lipase) |
|---|---|---|---|---|---|
| Molecular Formula | Molecular Weight | Core Functional Dimensions | Diagnosis of acute pancreatitis (especially early/severe), assessment of disease severity, and assessment of pancreatic exocrine function in chronic pancreatitis | ||
| Disease | Acute pancreatitis (AP) | Disease Subtypes | / | ||
| Organ | Pancreas | Test Sample / Technology Platform | Serum (biochemical analyzer, enzyme rate method, immunoturbidimetric method, etc.) | ||
| Pathobiological Mechanisms | Lipase, which is mainly synthesized by pancreatic acinar cells and secreted into pancreatic juice, is the key enzyme in the digestive tract to hydrolyze fat (triglycerides) into fatty acids and glycerol, and is produced almost exclusively by the pancreas (few other tissue sources). During the attack of acute pancreatitis, the pancreatic acinar cells were damaged and ruptured, and a large amount of pancreatic lipase was released into the blood. The serum lipase level began to increase at 4-8 hours after the onset of pancreatitis, reached the peak at 24-72 hours, and lasted for 7-14 days, which was significantly longer than that of amylase, and could reflect the state of pancreatic inflammation more persistently. For severe acute pancreatitis, lipase has a longer half-life and a certain amount of lipase is still released when pancreatic necrosis occurs. The positive rate of lipase elevation (about 90%-95%) is higher than that of amylase, and it is related to the degree of pancreatic fat necrosis. In chronic pancreatitis, with the gradual atrophy of pancreatic acinar cells and the decline of exocrine function, serum lipase level can be gradually decreased, which can be used to evaluate the degree of pancreatic exocrine function damage. | ||||
| Clinical Availability Status | It is recommended as a core diagnostic marker by the guidelines for the diagnosis and treatment of acute pancreatitis at home and abroad. It has irreplaceable value especially in the early diagnosis of acute pancreatitis and the diagnosis of suspected cases with normal amylase. It is also used for the evaluation of pancreatic function in chronic pancreatitis. | ||||
| Notes and Dynamics | Lipase is "the core index better than amylase" in the diagnosis of acute pancreatitis. It has the advantages of high specificity (only the main secretion of the pancreas), high sensitivity (higher positive rate in acute pancreatitis), and long duration, which can effectively make up for the lack of specificity of amylase and the defect that it may not be elevated in severe patients. It is especially suitable for the diagnosis of suspected acute pancreatitis patients with normal or slightly elevated amylase, and the disease monitoring of patients with a long course of disease. However, it should be noted that a few diseases such as biliary tract diseases (such as cholecystitis, cholangitis) and pancreatic tumors may also lead to mild elevation of lipase. Clinical interpretation should be combined with symptoms and imaging examinations. In addition, its detection cost is slightly higher than that of amylase, but its comprehensive diagnostic value is higher, and it has become "one of the preferred indicators" for the diagnosis of acute pancreatitis. | ||||