Lipase: normal, high and low levels of lipase in the blood. Lipase: normal, high, low blood levels

Pancreatic lipase Pancreatic lipase is synthesized in the pancreas and enters the duodenum as part of the pancreatic juice.

On the imageabove-right: human pancreatic lipase (secondary structures are highlighted in colors: alpha helices are shown in red, beta sheets in yellow, random helix in green) in complex with porcine colipase ( of blue color) and a small inhibitor molecule (upper left).

Lipase has a hydrophilic and hydrophobic part and acts only on the water-fat interface. Pancreatic lipase catalyzes the decomposition of dietary fats (triglycerides) into glycerol and higher fatty acid, forming first 1.2 and 2.3-diglycerides, and then 2-monoglycerides. For one molecule of triglyceride, two molecules of fatty acids are released. This process takes place in the cavity small intestine through intestinal digestion. Hydrolysis of 2-monoglyceride is very slow under the influence of monoglyceride lipase. This produces glycerol and fatty acids.

Pancreatic lipase may be adsorbed to the glycocalyx. Lipase hydrolyzes triglycerides by interacting with another pancreatic enzyme, colipase, a small protein with a molecular weight of less than 11,000 daltons. Bile acids at high concentrations inhibit the activity of lipase in the absence of colipase, preventing its contact with triglycerides. If lipase is associated with colipase, then they can be adsorbed on the surface of water - triglyceride, and carry out their enzymatic action. In addition, phospholipids and bile cholesterol are transported to the water-fatty surface or onto it with the help of the lipase-colipase complex.

Pancreatic lipase has a molecular weight of 48,000 units and an optimum catalytic activity of pH 8-9. In the catalytic center, pancreatic lipase contains a histidine and serine residue. The catalytic activity of pancreatic lipase is significantly increased by colipase, also present in pancreatic juice.

Lipase in enzyme preparations

Lipase is active components in many enzyme preparations used to correct digestive disorders, as well as to regulate the functions of the pancreas. Most often this complex preparations containing the main enzymes of the pancreas of domestic animals. These drugs help relieve clinical signs exocrine insufficiency pancreas, which include loss of appetite, nausea, borborygmi, flatulence, steatorrhea, creatorrhea and amylorrhea. The most popular pancreatic enzyme complex containing lipase is pancreatin. In addition to it, there are many other drugs containing lipolytic enzymes, incl. lipase, some of them are given in the table (Sablin O.A., Butenko E.V., drug formularies):

medicinal product	Dosage form	at least
Gastenorm forte	Enteric coated tablets	3500
Digestal	Dragee	6000
Creon 8000	Microspheres in capsules	8000
Creon 25000	Minimicrospheres in capsules	25000
Licrease	Microspheres in capsules	12000
Mezim-forte	Pills	3500
Mezim-forte 10 000		10000
Mezim 20000	Enteric coated tablets	20000
Panzinorm forte	Dragee	6000
Panzinorm forte-N	Pills	20000
Panzistal, enzistal	Pills	6000
Pancreatin (ICN, Yugoslavia)	Dragee	4300
Pancreoflat	Pills	6500
Pankurmen	Pills	875
Pantsitrat 10 000	Microtablets in capsules	10000
Pantsitrat 25 000	Microtablets in capsules	25000
Solizim	Pills	20000
Festal	Dragee	6000
Festal N	Dragee	6000
Enzistal	Pills	6000

On the site in the catalog of literature there are sections "Secretion, digestion in the gastrointestinal tract" And "Enzymatic preparations" containing publications on the physiology of digestion and the correction of the state of the digestive tract with enzyme preparations.

Lingual lipase

Lingual lipase is a digestive enzyme, lipase, produced by glands located in the mouth. The function of lingual lipase is to break down milk fats, mainly triacylglycerols, in infants.

The glands that produce lingual lipase are located in the mucous membrane of the root of the tongue and the adjacent region of the pharynx. baby. Their stimulation occurs when mechanoreceptors are stimulated during sucking and swallowing movements during natural breastfeeding. Milk is swallowed quickly and lingual lipase, mixed with milk, begins to act only in the stomach. The optimal acidity for lingual lipase is 4-5 pH, equal to the acidity of the gastric juice of infants.

With a change in the nature of nutrition, the need for lingual lipase decreases, the glands of the oral cavity reduce the amount of lingual lipase produced and its importance in the digestion of fats decreases. In adults, the secretion of lingual lipase is low.

Blood test for lipase

In diseases of the pancreas, lipase activity is significantly increased and lipase in in large numbers begins to be released into the blood. With inflammation of the pancreas, its amount in the blood increases markedly. After acute attack pancreatitis, the level of lipase in the blood serum increases after 4-8 hours up to 200 times, reaching a peak after 24 hours, and decreases after 8-14 days. The determination of lipase in pancreatitis has a high clinical sensitivity and specificity. The simultaneous determination of lipase and amylase makes it possible to diagnose pancreatic lesions with an accuracy of up to 98%. The norm of lipase for adults is up to 190 units / ml, for children from up to 18 years old - up to 130 units / ml (when examined by the turbidimetric method).
diseases accompanied by metabolic disorders, and especially lipids - obesity, diabetes mellitus, gout

parotitis with simultaneous damage to the pancreas.

A low level of lipase in the blood serum can be with:

• oncological diseases other than pancreatic cancer
• a diet that is high in fat

Lipase - food supplement

Lipase (Lipases) is registered as a food additive with the international code E1104. The primary use of lipase in this capacity is as a flavor and aroma enhancer. Until August 1, 2008, she was on the list food additives allowed for production food products V Russian Federation(SanPiN 2.3.2.2364-08). However, by the Decree of the Chief State Sanitary Doctor of the Russian Federation dated May 26, 2008 No. 32, lipase was excluded from this list.

Most people do not know what lipase affects in the blood, what the consequences of an increased or decreased level of this enzyme can be, what is the norm of its content.

Experts say that this issue is very important, since a deviation from normal indicators often indicates the presence of serious diseases in the body.

Lipase is one of the digestive enzymes. The enzyme is produced by several organs at once - the liver, pancreas, intestines, and lungs.

Lipase plays an important role in the processing of food, as it affects the breakdown of fats. various kinds absorption of certain vitamins and acids by the body. As a rule, the human blood contains the most enzyme produced by the pancreas.

Lipase, produced by the liver, takes an important part in the digestive processes - it promotes the absorption of lipoproteins and chylomicrons.

In addition, the enzyme regulates the amount of lipids in the blood. Gastric lipase breaks down tributyrin (a fat found in oils).

In very young children, the enzyme can be produced by the oral cavity - this is necessary for better assimilation breast milk. In the future, the glands that produce lipase atrophy.

In children and adolescents under the age of seventeen, the presence of 0 to 130 units of lipase per milliliter of blood is considered normal.

In men and in older women, the norm rises to 190 units. Lipase produced by the pancreas, or pancreatic, should be contained in one milliliter of blood in an amount of up to 60 units.

As a rule, along with the analysis for lipase, the content of another enzyme, amylase (an enzyme that breaks down starch in foods), is checked.

When proper preparation similar procedure allows almost with absolute probability to diagnose diseases of the pancreas in a patient. This is due to malfunctions in the work of the body and increased production lipase in the blood.

It should be noted that the analysis for the content of the enzyme may be unreliable.

This happens when, due to insufficient production of enzymes, a person takes various enzyme-containing drugs, which also include lipase.

Such medications include Mezim, Creon, Festal, Panzinorm. Before carrying out the analysis, it is imperative to warn the doctor about the course of treatment with these drugs.

The enzyme level may change due to the use of various barbiturates (hypnotics and sedatives), narcotic-based analgesics (painkillers).

In addition, the level of lipase in the blood increases when taking indomethacin (an anti-inflammatory drug) and heparin ( medication, which thins the blood and worsens its coagulability, is used in the formation of blood clots).

Indications and preparation for analysis

The doctor may order a blood test for lipase if there is a suspicion that the patient has developed various diseases.

At acute pancreatitis the content of the enzyme is much higher than normal, especially on the third day after the attack. A blood test allows you to successfully diagnose the disease and begin treatment.

Chronic pancreatitis is less severe and lipase increases only slightly because the pancreas produces fewer enzymes over time.

When neglected, parotitis can lead to the development of inflammatory processes in the patient's reproductive system. In women, the mammary glands may be affected.

In addition, the analysis is assigned various ailments gallbladder. The suspicion of the appearance of tumors in the pancreas is also considered the basis for checking the level of lipase in the blood.

Before submitting the material for analysis, it is imperative to prepare and fulfill some conditions voiced by the doctor. First of all, it must be borne in mind that blood is donated from a vein and only on an empty stomach.

From the moment of the last meal, at least eight, and preferably twelve hours must pass. For this reason, blood donation for analysis is almost always done in the morning.

Before the procedure, you are allowed to drink some water. It is strictly forbidden to take another liquid, as this may distort the results.

A day before taking a blood test for lipase, the patient is advised to refuse to eat fatty, spicy, smoked, spicy foods.

It is advisable to finish the course of treatment with various drugs a week before the procedure.

If this is not possible, then it is necessary to warn the doctor about all the medications taken. The rate of lipase in the blood at the same time slightly increases.

This is due to the possible distortion of the results due to the effect of radiation on the body. There are two research methods - immunochemical and enzymatic.

As a rule, the second method is used due to more high speed processing of received data. IN emergency cases, When we are talking about the life of the patient, a blood test can be taken without prior preparation.

Abnormal levels of lipase

If lipase is elevated in a person’s blood, then this gives the doctor a reason to suspect the development of certain diseases.

In addition to pancreatitis and parotitis, these can be biliary colic, cholecystitis (inflammation of the gallbladder), peritonitis (inflammation of the peritoneum), intrahepatic cholestasis(decrease in the production of bile and its entry into duodenum).

If the level of lipase is elevated, then this may also signal the appearance of tumors in the pancreas (cysts, benign or malignant tumors).

In addition, an upward deviation from the norm is considered a reason for diagnosing intestinal obstruction, heart attack, cirrhosis of the liver, stomach ulcers, perforation (rupture) of internal organs.

Elevated levels of lipase in the blood can be a symptom of various metabolic disorders, in particular diabetes, obesity, gout.

If the pancreas has been injured, then the level of the enzyme also usually increases. In some cases, after an organ transplant operation, the enzyme in the blood becomes higher than normal.

As a rule, with diseases of the pancreas and other organs, the level of the enzyme increases several times, sometimes a twenty-fold increase is observed.

After the start of treatment for a few days, the indicator returns to normal. If a patient has a tenfold excess for a long time normal level, then the prognosis of treatment is usually unfavorable.

In some cases, the content of lipase in the blood is below normal. This may signal the development of oncology in the body (it should be noted that pancreatic cancer does not manifest itself as such a symptom) or the transition of the inflammatory process to the chronic stage.

Enzyme levels are low malnutrition(too much food fatty foods) or hyperlipidemia - elevated content lipids in the blood (as a rule, the disease is inherited).

Lipases can also be less than normal due to the removal of the pancreas. Sometimes a person may develop cystic fibrosis (a disease that affects the intestines or the respiratory system).

As a rule, the prognosis for the treatment of this pathology is unfavorable - quite often the disease leads to death.

A blood test for the enzyme content is very important because it allows you to diagnose the disease on early stage and start treatment promptly.

Lipase is considered the most important enzyme, which is produced by several organs and is directly involved in the digestive processes.

A blood test for the content of this enzyme is prescribed for suspected presence of various diseases. Deviations from the norm allow you to diagnose diseases and begin timely treatment patient.

Allows you to evaluate the functioning of many human organs and systems. For the detection of pathologies of the pancreas, lipase is of particular value. This enzyme is responsible for the processing of fats and their decomposition. An increase and decrease in the indicator indicates the development of diseases of this organ.

Lipase is a digestive enzyme that promotes the breakdown and dissolution of fats. This enzyme is produced in various organs.

The main organs where this enzyme is produced are the liver, intestinal walls, and lungs. One of important organs is the pancreas. It is in it that pancreatic lipase is produced.

The function of this enzyme is the breakdown of fats.Lipase, which is formed in the liver, is responsible for the constant concentration of lipids in the plasma.

Lipase performs the following functions:

1. Promotes the absorption of vitamins.
2. Helps absorb fatty acids.
3. Takes part in energy exchange.

At normal functioning gastrointestinal tract the content of this enzyme will not change. With pathologies of the digestive system, an intensive release of lipase into the blood occurs, which means that its concentration increases.

Assign a blood test for the content of a digestive enzyme in acute and chronic pancreatitis, mumps, with suspicion of a tumor process, with problems with the gallbladder.

Diagnosis and norm of the enzyme

To determine the level of concentration of lipase in the blood, a blood test is performed. An analysis to determine lipase is prescribed if there are problems with the pancreas. Other varieties of lipase are concentrated in small quantities and other methods of research will be needed.

Research will need deoxygenated blood. Blood sampling is carried out on an empty stomach from a peripheral vein. There are 2 methods of blood testing for lipase content: enzymatic and immunochemical.The first method is used to get a quick result. Usually used to diagnose acute conditions.

To obtain more accurate information, blood should be donated on the 3rd day from the moment of the inflammatory process. Increased rate lipase is diagnosed for 14 days after which it decreases. If the indicator exceeds the norm for more than two weeks, then this indicates adverse effects.

The level of lipase in the blood depends on the age of the person, but the indicator does not depend on gender.

The normal content of lipase in the blood should be 130 units / ml and not exceed the specified rate for children under 17 years of age. The enzyme level in persons over 18 years of age should not exceed 190 units / ml.

What are the main reasons for the increase?

Pancreatic lipase in determining diseases of the pancreas has a high diagnostic value. In pathological processes in the pancreas, the concentration of this enzyme increases several times.

On early stage development, the level of lipase increases slightly, so the diagnosis of the disease is difficult and it is necessary to study additional markers.

An increase in the level of lipase can be observed in the following cases:

• Pathology of the gallbladder.
• Perforation of the stomach.
• Intrahepatic cholestasis.
• Intestinal diseases.
• tumor processes.
• Peritonitis.
• Autoimmune diseases.

A high content of lipase in the blood indicates an inflammatory process in the digestive system, namely in the pancreas, which proceeds in an acute form.

From the video you can find out the main symptoms of pancreatitis:

The reason for the increase in the enzyme in some cases may be a fracture of the tubular bone and various injuries.An increase in the concentration of a digestive enzyme is detected in people who take analgesics or barbiturates. In this case, the indicator will not be overestimated.

Why is a high level of lipase dangerous?

Blockage of the duct provokes an increase in pressure, the tissues of the organ are destroyed and digestive enzymes are released into the bloodstream. An increase in lipase by several times is quite dangerous state and can result in serious consequences.

There is a rapid activation of the enzyme and its own enzymes damage the tissues of the body and lead to their death. Against the background of pancreatitis in an acute form, damaged internal organs and fabrics. The most common consequence of this is renal or liver failure, intoxication shock, acute heart failure, sepsis.

Features of treatment and prognosis

In many cases, an increase in lipase in the blood indicates diseases of the pancreas. Treatment will consist in eliminating the cause that provoked the increase in the indicator. In case of pancreatic pathologies, anti-inflammatory drugs, antispasmodics, antisecretory agents, as well as drugs to normalize the production of pancreatic enzymes are prescribed.

In diseases of the gallbladder and an increase in the level of lipase against this background, an etiotropic and pathogenetic therapy. The patient is prescribed antibiotics, as well as preparations containing enzymes: Mezim, Festal, Pancreatin.

At tumor processes surgical treatment is performed.

In a particular case, the doctor prescribes a treatment regimen taking into account the patient's condition and symptoms.If at the time of treatment the level of lipase exceeds the norm by 10 times and after drug therapy the indicator does not decrease, then the prognosis is unfavorable.

Lipase is a substance produced human body, which promotes fractionation, digestion and splitting of neutral lipids. Together with bile, a water-soluble enzyme starts the digestion of fatty acids, fat, vitamins A, D, K, E, converts 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 the cells is ensured. The pancreas, intestines, lungs, and liver are responsible for the secretion of pancreatic lipase.

In young children, the production of the enzyme is also carried out by a number of special glands, their localization in oral cavity. Any of the pancreatic substances is designed to digest certain groups of fats. Pancreatic lipase in the bloodstream is an accurate marker for the onset of an acute inflammatory process in the organ.

Lipase functions

The main function of lipase is fat processing, splitting and fractionation. In addition, the substance takes part in the assimilation of a number of vitamins, polyunsaturated fatty acids, and energy metabolism.

Most valuable substance pancreatic lipase, produced by the pancreas, becomes the one that ensures the complete and timely absorption of fats. IN digestive system it penetrates in the form of prolipase - an inactive enzyme, the activator of the substance will be another pancreatic enzyme colipase and bile acids.

Pancreatic lipase is broken down by lipids emulsified by hepatic bile, which accelerates the breakdown of neutral fats in food into glycerol, the higher fatty acids. Thanks to hepatic lipase, low-density lipoproteins, chylomicrons, are assimilated, and the concentration of fats in the blood plasma is regulated.

Gastric lipase stimulates the breakdown of tributyrin, the lingual variety 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 normal the number 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 IU/ml.

What does an increase in lipase mean?

If pancreatic lipase is elevated, this is important information when making a diagnosis, it becomes an indicator of the development of certain disorders in the pancreas.

Can increase the concentration of a substance serious illnesses, including the acute form of pancreatitis, biliary colic, malignant and benign neoplasms, pancreatic injuries, chronic gallbladder diseases.

Often, an increase in lipase speaks of cysts and pseudocysts in the pancreas, blockage of the pancreatic duct with stones, a scar, and intracranial cholestasis. Causes pathological condition will become acute intestinal obstruction, peritonitis, acute and chronic kidney failure, perforation of gastric ulcer.

In addition, an increase in lipase becomes a manifestation of:

1. perforation of a hollow organ;
2. metabolic disease;
3. obesity;
4. any ;
5. mumps with damage to the pancreas;
6. gouty arthritis;
7. transplantation of internal organs.

The problem sometimes develops with prolonged use of certain medicines: barbiturates, narcotic-type analgesics, Heparin, Indomethacin.

It is not excluded 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, the analysis for lipase is almost never prescribed when diagnosing injuries of various etiologies.

In what diseases does lipase increase

The study of lipase levels in the blood becomes important when various lesions pancreatic tissues. Then the analysis for this enzyme is recommended to be carried out together with the determination of the amount of amylase, an enzyme that promotes the breakdown of starchy substances to oligosaccharides. If both indicators are significantly exceeded, this indicates the development of 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, often lipase remains elevated much longer than amylase.

Laboratory studies have shown that inflammatory process in the pancreas:

• the concentration of lipase grows only to moderate numbers;
• indicators rarely reach a level where the doctor can undoubtedly make an accurate diagnosis;
• the disease can be established only on the third day.

It needs to be taken into account that when severe swelling the level of the substance remains normal, the average rate of the enzyme is observed in the presence of fatty pancreatic necrosis. The degree of lipase activity increases approximately threefold with hemorrhagic form pancreatic necrosis.

High lipase persists for 3-7 days from the beginning acute inflammation, the tendency to the normalization of the substance is noted only on the 7-14th day of the pathological condition. When the pancreatic enzyme jumped to 10 and above, the prognosis of the disease is considered to be unfavorable, especially if the blood biochemistry showed that the activity persists for several days, does not fall to a threefold excess of the norm.

The rapid increase in pancreatic lipase has a specificity that is closely related to the cause of the disorder. differs in the growth of the enzyme 2-6 hours after the exacerbation, after 12-30 hours the lipase reaches peak levels and gradually begins to decline. After 2-4 days, the activity of the substance reaches the norm.

At chronic course of the disease, a slight increase in lipase is initially noted, as the disease develops, the transition to the remission phase, it normalizes.

Causes of low lipase levels

The development of malignant neoplasms any part of the body, not only the pathology of the pancreas. Also, the reasons should be sought in a decrease in pancreatic function, a genetic disorder with an extremely severe course that occurs due to damage to the glands. external secretion(disease cystic fibrosis).

After the surgical treatment to remove the pancreas, with an excessive content of triglycerides in the bloodstream, which was caused by an improper diet with an abundance fatty foods, hereditary hyperlipidemia also drops the level of pancreatic enzyme. Often, a decrease in the level of lipase is observed during the transition of pancreatitis from acute form to the chronicle.