Lipase
and Eva Rudolf-Müller, doctorValeria Dahm is a freelance writer in the medical department. She studied medicine at the Technical University of Munich. It is particularly important to her to give the curious reader an insight into the exciting subject area of medicine and at the same time to maintain the content.
More about the expertsEva Rudolf-Müller is a freelance writer in the medical team. She studied human medicine and newspaper sciences and has repeatedly worked in both areas - as a doctor in the clinic, as a reviewer, and as a medical journalist for various specialist journals. She is currently working in online journalism, where a wide range of medicine is offered to everyone.
More about the experts All content is checked by medical journalists.A lipase is an enzyme that breaks down fats (triacylglycerols, TAGs) into their components. This is the only way the body can 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 can tell you about the patient's health and which factors can increase or decrease the lipase level.
What is the lipase?
All enzymes that are able to break the bonds within certain fats - the triacylglycerols (TAGs) - are referred to as lipase. These consist of three fatty acids that are linked to one another via a glycerine molecule. The connection between fatty acid and glycerine is a so-called ester bond. Lipases can cleave such ester bonds.
Pancreatic lipase
The most important lipase for fat digestion is pancreatic lipase - pancreatic lipase. It is produced by the pancreas and passed into the duodenum, where it breaks down the dietary fats that are ingested. This is the only way to absorb them through the intestinal mucosa. Here the fatty acids and glycerols are linked again to TAGs and bound to certain molecules, the lipoproteins. The lipoproteins are the transporters of the normally insoluble fats in the blood.
Lipoprotein lipase
In contrast to 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 again into fatty acids and glycerol. Then fats can be absorbed into the cells and stored there as a reserve.
Hormone sensitive lipase
Stored fat is also in the form of TAGs. It has to be broken down into its individual parts by the hormone-sensitive lipase, which are located in the fat cells, in order to generate energy. These then reach the organs via the blood, which have to meet their energy needs 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 pancreatic lipase in particular is measured in the laboratory. It provides information on diseases of the pancreas. These include inflammation (pancreatitis), tumors, or other diseases that affect the pancreas (such as an acute abdomen). Amylase, another enzyme in the pancreas, is often determined at the same time.
In general, the determination of lipase is not a routine examination, but is only carried out if a disease is suspected.
Lipase normal value
The blood lipase level can be determined in both serum and plasma. The unit of measurement U / l stands for the enzyme unit (U) per liter.
|
Pancreatic lipase: normal value | |
|
up to 1 year |
<34 U / l |
|
2 to 12 years |
<31 U / l |
|
13 to 17 years |
<55 U / l |
|
adult |
5.6 - 51.3 U / l |
When is the lipase low?
If the lipase level is low, there is usually no cause for concern. A low blood lipase level is only very rarely caused by a disease such as:
- cystic fibrosis (cystic fibrosis)
- chronic inflammation of the pancreas (pancreatitis)
An erroneously low value can also be measured in the event of a severe breakdown of the blood cells.
When is the lipase increased?
The causes of an increase in lipase are usually in the pancreas itself:
- chronic or acute inflammation of the pancreas (pancreatitis)
- Pancreatic tumors
- Involvement of the pancreas in other conditions such as an acute abdomen
- Closure of the duct between the pancreas and the duodenum (ductus pancreaticus)
- Irritation of the pancreas due to an invasive procedure (endoscopic retrograde cholangiopancreatography = ERCP)
If the lipase is only slightly increased, this can be due to the following reasons:
- Kidney failure (renal failure)
- Inflammation of the liver (hepatitis)
- bacterial intestinal infections
- diabetic ketoacidosis (dangerous metabolic imbalance in diabetics)
- Gluten intolerance
- inflammatory bowel disease
Falsely high values are measured with a pathological increase in fats in the blood (hypertriglyceremia) or therapy with heparin (an anticoagulant).
What to do if the lipase value has changed?
If your lipase level is low, your doctor may take a second measurement. In most cases, however, there is no need for action.
If the lipase level is increased, 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 but effective tests are carried out even if the lipase level is too high, but no symptoms occur.
The treatment depends in each case on the underlying disease. In the case of pancreatitis, for example, this includes abstaining from alcohol, coffee and cigarettes, regular consumption of small meals and controlled fluid intake. The latter can also be done through the vein. However, care must be taken that the level of lipase does not correlate with the severity of the course of the disease.
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