Which drug contains lipase. Lipase: normal, high, low blood levels. Why might there be a drop?

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

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

Types of lipase and its purpose

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

pulmonary;
leukocyte;
pancreatic;
gastric;
intestinal.

In the oral cavity of infants, there are glands that produce the so-called lingual lipase, which promotes the breakdown of fats. breast milk immediately after swallowing it. As the child grows older, 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 intestine along with pancreatic juice and takes an active part in digestion.

Normally, the content of this type of enzyme in the blood is almost 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 circulatory system. Therefore, the analysis of the level of lipase in the blood serum is the most specific study in the diagnosis of acute attacks of pancreatitis.

The norms of the content of lipase in the blood

The interpretation of the results of studies in the biochemical analysis of blood is guided by 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.

When is an analysis ordered?

Indications for the appointment of an analysis for the level of lipase in the blood may be the suspicion of the attending physician for the development of the following pathologies:

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

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

What does an increase in lipase in the blood mean?

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

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

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

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

This high serum enzyme content persists for 1-2 weeks, after which a downward trend is observed (a decrease from a 20-fold increase to a 3-fold increase is considered normal). long-term storage high performance lipase in excess of the norm by 10 times or more is considered an extremely unfavorable prognosis of the disease.

Among women common cause increasing lipase becomes a long-term intake of some medicines, mainly analgesics, barbiturates, some antibiotics.

The results of the study can also be affected by such factors as the emotional state of the patient, physical or psychological overwork, and stress.

When lipase levels are low

Causes of low enzyme levels can mean such dangerous predictions as:

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

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

Of course, all these assumptions can become diagnoses only on the basis of the results of additional studies and a 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 food intake, drinking alcoholic beverages and quitting smoking in the next half hour before donating blood.

Doctors pay great attention to blood tests not just like that. 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 digestion is not going according to plan.

Before explaining the role of lipase as an enzyme, it should be explained what "enzymes" are and why they are needed. An enzyme (synonym: enzyme) is a special molecule that breaks down some chemical compound into simpler components. There are a large number 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 splits it 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 do not physically fit it in shape.

After successful cleavage, the enzyme releases environment decay products and is looking for the next "victim".

Lipase is common name for a group of enzymes (certain types discussed in the next subsection). Lipase functions: breakdown of fats, phosphorus compounds and some vitamins. Lipase is produced by many tissues of the body, but the main share is in the pancreas. Behind it according to the “rating” is the liver, after the liver: lungs, saliva, intestines. The rate of lipase in the blood: from 0 to 190 units / liter.

Lipase types

Lipase is divided into:

Lipoprotein lipase. This species is produced by many tissues, with the highest concentrations found in the heart, muscle, and adipose tissue. Lipoprotein lipase breaks down lipids (fats) circulating in the blood. If this type of lipase is deficient, the patient is at increased risk of atherosclerosis because undigested fat settles on the inner walls of the blood vessels.
pancreatic lipase. This enzyme is the main among lipases, it is produced by the pancreas and enters the intestine, where it breaks down fats. Pancreatic diseases lead to increased production of the enzyme, and it begins to enter the bloodstream, which is reflected in the tests.
Hepatic lipase. This lipase is almost identical to pancreatic lipase in its action, but it does not enter the intestines, but immediately into the blood. Together with lipoprotein lipase, they break down fats circulating in the bloodstream.
Phospholipase. This type destroys fats, which contain phosphorus. Phospholipase is essential for the body, because the phosphorus that comes with food is converted into ATP, a molecule that stores energy in itself and delivers it to other cells. Phospholipase is divided into several types (A1, A2, B, C, D), but only those who are familiar with biological chemistry will understand the difference between them.

The day before the analysis, you should not eat fatty foods, because this will distort the results.

Is there an error in the study?

Unlikely, but possible.

Causes:

Eating fatty foods before taking the test. If you eat something fatty, then the 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. With fractures, the enzyme contained in these bones is released into the blood, which causes an unreasonably increased rate.

Increased values

Lipase is increased 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 it needs, or the body does not have time to utilize the excess.

Possible reasons:

acute or chronic pancreatitis;
a malignant tumor or cyst in the pancreas;
intestinal obstruction;
peritonitis;
bone fractures, soft tissue injuries;
kidney failure;
obesity, diabetes;
taking barbiturates.

By itself, the increase does not affect the patient's well-being, but its causes are clearly felt (it is quite difficult not to notice intestinal obstruction or a fracture).

To bring the level of lipase back to normal, you need to eliminate the root causes of its increase. This must be done as quickly as possible, because all causes (except obesity, soft tissue injury and chronic pancreatitis) threaten the health and life of the patient here and now. Methods of treatment depend on the specific pathology, the doctor should choose the treatment regimen.

Lipase is a water-soluble enzyme that is synthesized by the human body. It catalyzes the hydrolysis of insoluble esters and also aids in digestion, dissolution and fractionation.

Main function

The enzyme lipase, together with bile, promotes the digestion of fats as well as fatty acids. It is involved in the processing of fat-soluble vitamins A, E, D, K and transforms them into heat and energy.

Lipase in the blood breaks down triglycerides (lipids). Thanks to this, fatty acids are delivered directly to the tissues of the body.

Which organs produce lipase

In the human body, the enzyme lipase is produced:

in the pancreas;
in the liver;
in the lungs;
in the intestine.

In addition, the enzyme is produced in infants in the oral cavity due to special glands. In babies, lingual lipase is synthesized, which acts on milk fats.

Each organ supplies which breaks down strictly defined groups of fats.

Appointment of lipase in the human body

So, main mission lipases of any type are the processing of fats, their splitting and fractionation. Also, this substance is actively involved in the exchange of energy, promotes the absorption of polyunsaturated fatty acids, certain vitamins.

The most important enzyme is produced by pancreatic lipase - an enzyme by which lipids are absorbed completely and fully. It enters the digestive tract, where, under the influence of colipase, which is also a pancreatic enzyme, it combines with and is converted into an active form. Pancreatic lipase performs an important role - it breaks down triglycerides (neutral fats) into two components: glycerol and higher fatty acids.

Differences between different types of lipase

As noted above, different types lipases interact with certain types of fats.

Hepatic lipase works with low density lipoproteins. It is she who acts as a regulator of plasma lipids.

Gastric lipase actively breaks down oil tributyrin. Lingual is involved in the breakdown of fats contained in breast milk.

Norm and deviation

By the level of how much lipase is present in the blood, one can judge the state of the human body. Deviations in the direction of increase or decrease allow physicians to determine diseases associated with gastrointestinal tract. Therefore, when complaining of ailments, doctors prescribe general analysis. Lipase - what is it: norm or deviation? There are certain general criteria.

In adults, regardless of gender, who are 17 years old, the lipase index per 1 milliliter of blood should be from 0 to 190 units.
For children and adolescents, this figure is slightly lower and should normally fall within the range from 0 to 130 units.
If the level of pancreatic lipase is being examined, then the norm will be 13-60 units of the enzyme per 1 ml of blood. Anything above these indicators indicates a malfunction in the body.

If the values are above the norm

If lipase is elevated, is it worth sounding the alarm? Yes, this fact must be paid close attention to. And only a doctor with the help of tests and additional examination methods can make an accurate diagnosis. After all, lipase is an enzyme involved in many metabolic processes, and only a specialist can determine which organ is suffering.

Lipase is increased in such diseases:

Pancreatitis. This enzyme becomes more in acute forms of the disease, as well as during an exacerbation of a chronic process.
Biliary colic.
Injury to the pancreas, as a rule, is accompanied by a sharp rise in this enzyme.
Neoplasms in the pancreas.
Chronic pathologies of the gallbladder contribute to a large amount of lipase production.
The presence of a cyst in the pancreas.
Blockage of the pancreatic duct by a stone or scar.
Intrahepatic cholestasis.
Acute intestinal obstruction.
Peritonitis.
Perforated stomach ulcer.
Perforations of internal organs.
Parotitis.

As you can see, the list of diseases in which the level of lipase in the blood rises is very large. Add to it the numerous metabolic disorders in the body that accompany diabetes mellitus, gout or obesity, as well as cirrhosis of the liver or prolonged misuse of medications, and the list will double. It is worth remembering that lipase is an enzyme that is actively involved in metabolic process, so any operation can also provoke its increased production in the body.

Therefore, you should never make a diagnosis on your own, solely on the basis of analyzes and having read medical books. Only a specialist, relying on a complex of other studies, can accurately identify the cause of the pathology and develop the correct recommendations for treatment.

Important nuances

Sometimes lipase begins to be intensively produced after trauma. With a fracture, an increase in this enzyme in the blood is observed. And doctors know this too.

The level of lipase is very important to accurately determine when the pancreas is affected. If the levels of amylase (an enzyme that breaks down starch) are too high in the blood, then the doctor can diagnose the pathology of the pancreas with great confidence.

As soon as it is possible to remove inflammation from the diseased organ, both of these indicators return to normal. True, amylase is restored much faster. But lipase can be above the norm for a long time.

In this case, the amount of the enzyme does not increase immediately. If pancreatitis has begun, then on the first day the lipase indicators are still in allowable rate. Very rarely they rise immediately. Usually, according to the analyzes, the disease is determined only on the third day.

After the onset of the inflammatory process, a high level of lipase is observed from three to seven days. And only then the indicators gradually fall.

Particular attention should be paid if the level of lipase is exceeded 10 times or more. Doctors consider such indicators extremely unfavorable. In this case, immediate treatment is required.

Decreased amount of lipase in the blood

A low level of this enzyme is observed:

If there is a malignant neoplasm in the body, and not only in the gastrointestinal tract.
If the function of the pancreas is reduced.
With cystic fibrosis (or otherwise cystic fibrosis). This is a severe genetic disease with relapses, requiring long-term treatment. It occurs due to a pathological lesion of the external secretion glands.
After surgery, when the pancreas is removed.
Due to malnutrition, when present in the diet a large number of fatty food.

Doctors also note that if the level of lipase is reduced for a long time, this may indicate that pancreatitis has become chronic.

If you have problems with metabolism, with the gastrointestinal tract, it is simply necessary to monitor the level of lipase in the blood. This is an important indicator that will allow timely detection of the disease and start timely treatment.

Lipase is an enzyme whose main purpose is to dissolve, fractionate and digest fats in the human digestive tract.

Lipase is produced by the pancreas, lungs, liver, and intestines. There is also such a thing as lingual lipase - this is a substance that is produced in the mouth of newborns.

Each of these enzymes is responsible for the breakdown of a separate group of fats.

Another important function of lipase is participation in energy metabolism, the process of assimilation of vitamins A, D, E, K, polyunsaturated fatty acids.

Lipase norm

There are certain norms for the content of lipase in the blood.

Children under 17 years of age should contain from 0 to 130 units of lipase in 1 ml of blood.

The permissible rate of lipase for adults, regardless of gender, is 0-190 units of the enzyme per 1 ml of blood.

The level of lipase is determined using a blood test. It is usually prescribed to patients with chronic or acute pancreatitis, cirrhosis of the liver, acute cholecystitis, diabetic ketoacidosis, chronic and acute renal failure, acute intestinal obstruction, stomach ulcers, as well as those who have undergone an organ transplant operation.

Especially important is the analysis of the level of lipase for those who have affected the pancreas. A blood test for lipase and another enzyme, amylase, gives an accurate result in 98%, and indicates a disease of the pancreas.

How to prepare for a lipase blood test

Blood for analysis is taken from a vein, on an empty stomach. A person 12 hours before blood sampling should not eat anything fatty, spicy and spicy. Only in extreme cases, the analysis for the level of lipase is carried out without preparation, at any time of the day.

Today, two methods of blood testing for lipase content are used: immunochemical and enzymatic. The second is used more often, because the result with its help can be obtained faster.

What does elevated lipase mean?

If lipase is elevated, doctors may suspect that a person has the following diseases:

biliary colic;
pancreatitis in the acute stage or exacerbated chronic pancreatitis;
neoplasms in the pancreas, incl. cysts or pseudocysts;
metabolic disorders (obesity, gout, diabetes, etc.);
heart attack or intestinal obstruction;
perforation of the internal genital organs;
peritonitis;
intrahepatic cholestasis;
perforated stomach ulcer;
epidemic parotitis - if it is accompanied by damage to the pancreas.

The fact that lipase is elevated may also indicate that a person is taking Heparin, Indomethacin, narcotic analgesics, barbiturates.

Although it is not customary to do a blood test for lipase with physical injuries, an increase in the level of this enzyme can be observed in people with fractures of tubular bones and other serious injuries.

The level of pancreatic lipase is very important for diagnosing diseases, but it is difficult to make an accurate diagnosis only by such a blood test - on the first day of exacerbation of pancreatitis, lipase rises moderately and only on the third day can serious enzyme activity be detected. So, if the defeat of the pancreas is accompanied by the appearance of edema, the level of lipase is within the normal range, if the patient has hemorrhagic pancreatic necrosis (one of the complications of acute pancreatitis), then the amount of lipase will exceed the norm by three or more times. And if a person has fatty pancreatic necrosis, then there will be no significant increase in the level of lipase.

The prognosis of pancreatic damage is considered unfavorable if the level of lipase is increased by 10 or more times, and if it does not decrease to three times the norm in three days.

The increased activity of lipase usually persists for 3-7 days from the onset of inflammation, and the level of lipase begins to recover only after 7-14 days.

What does low lipase mean?

The fact that lipase is lowered may indicate the presence of cancer. The exception is pancreatic cancer.

In addition, lipase may be lowered in hereditary hyperlipidemia ( elevated level lipids in the blood), poor diet, which is dominated by fats.

The lack of lipase may also indicate that pancreatitis has passed from acute to chronic form.

Lipase - what is it? In the human body there are enzymes that are vital. They ensure the normal process of digestion of food, contribute to 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 such enzyme is lipase.

1 Description of indicator

The peculiarity of enzymes is that they serve as catalysts that can stimulate the appearance of interaction the right substances and support him. 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 compound of protein molecules that affects insoluble esters, stimulates the process of their catalysis, breaks down and normalizes the digestion of neutral fats, their dissolution and fractionation.

In promoting the process of digestion of fats, lipase is not alone and acts together with bile. Together with fats, lipase breaks down and digests fatty acids. In addition, the enzyme takes part in the process of converting fat-soluble vitamins such as A, E, D and K into heat. Together with heat, the body also receives energy.

Lipase has the ability to act on lipids, causing them to 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 it needs a lot. In order to insure a person, nature endowed him with a structure in which enzymes are produced by several organs at once, namely:

pancreas;
lungs;
liver;
intestines.

In newborns, this enzyme is produced in the mouth. This is ensured by the presence of special glands. As a result, in infants, there is a process of synthesis of lingual lipase, which is necessary to act on milk fats.