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Lipase: what the blood value means

by Josephine Andrews
Published: Last Updated on 317 views

lipase is an enzyme that breaks down fats (triacylglycerols, TAGs) into their components. This is the only way the body can both digest dietary fats and use its own fat reserves to generate energy. Find out here when the lipase levels in the blood are measured, what they reveal about the patient’s health and which factors can increase or decrease the lipase levels.

What is the lipase?

All enzymes that are able to split the bonds within certain fats – the triacylglycerols (TAGs) – are called lipases. These consist of three fatty acids that are connected to each other via a glycerol molecule. The connection between fatty acid and glycerin is a so-called ester bond. Lipases can cleave such ester bonds.

pancreatic lipase

The most important lipase for fat digestion is the lipase of the pancreas – pancreatic lipase. It is produced by the pancreas and sent to the duodenum , where it breaks down the ingested fats. This is the only way they can be absorbed through the intestinal mucosa. Here, the fatty acids and glycerols are reconnected to form TAGs and bound to specific molecules called lipoproteins. The lipoproteins are the transporters of the normally insoluble fats in the blood .

lipoprotein lipase

Unlike pancreatic lipase, lipoprotein lipase is found in the blood and on the walls of fat cells and blood vessels. It splits the TAGs on the lipoproteins back into fatty acids and glycerol. Fats can then be absorbed into the cells and stored there as a reserve.

Hormone sensitive lipase

Stored fat is also in the form of TAGs. In order to generate energy, it has to be broken down into its individual parts by the hormone-sensitive lipase in the fat cells. These then reach the organs via the blood, which have to cover their energy requirements with the help of fatty acids.

gastric lipase

In addition to pancreatic lipase in the intestine , lipoprotein lipase in the blood and hormone-sensitive lipase in the cells, the body also produces gastric lipase. However, this only contributes to fat digestion in infants.

When is the lipase value determined?

The pancreas lipase in particular is measured in the laboratory. It gives indications of diseases of the pancreas. These include inflammation (pancreatitis), tumors, or other diseases that affect the pancreas (such as acute abdomen). Amylase , another pancreatic enzyme, is often determined at the same time .

In general, the determination of the lipase is not a routine test, but is only carried out if a disease is suspected.

Lipase normal value

The lipase blood value can be determined both in serum and in plasma. The unit of measurement U/l stands for the enzyme unit (U) per liter.

Pancreatic lipase: normal value
up to 1 year < 34U/L
2 to 12 years < 31U/L
13 to 17 years < 55U/L
Adult 5.6 – 51.3 U/l

When is lipase low?

If the lipase is low, there is usually nothing to worry about. Only very rarely is a reduced lipase blood value based on a disease such as:

A falsely low value can also be measured if the blood cells break down severely.

When is lipase elevated?

The causes of an increase in lipase are usually in the pancreas itself:

  • chronic or acute inflammation of the pancreas (pancreatitis)
  • tumors of the pancreas
  • Involvement of the pancreas in other conditions such as an acute abdomen
  • Closure of the duct between the pancreas and the duodenum (pancreatic duct)
  • Irritation of the pancreas by an invasive procedure (endoscopic retrograde cholangiopancreatography = ERCP )

If the lipase is only slightly increased, this can have the following reasons:

  • Kidney weakness ( renal insufficiency )
  • Inflammation of the liver ( hepatitis )
  • bacterial intestinal infections
  • diabetic ketoacidosis (dangerous metabolic imbalance in diabetics)
  • gluten intolerance
  • chronic inflammatory bowel disease

Falsely high values ​​are measured with a pathological increase in fats in the blood (hypertriglycerdiaemia) or therapy with heparin (an anticoagulant).

What to do if the lipase value changes?

If the lipase level is low, your doctor may take a second measurement. In most cases, however, there is no need for action.

If the lipase is elevated, a thorough investigation should be carried out. In addition to a second blood count with other parameters and a stool examination , this also includes an ultrasound of the abdominal organs. These simple, yet effective tests are also carried out when the lipase level is too high, but there are no symptoms.

The treatment always depends on the underlying disease. In the case of pancreatitis, for example, this includes abstaining from alcohol, coffee and cigarettes, eating small meals regularly and controlling fluid intake. The latter can also be done via the vein. However, care must be taken to ensure that the level of lipase does not correlate with the severity of the course of the disease. 

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