What are the normal levels of lipase (enzyme)

From the Guidelines

Normal lipase levels are typically considered to be less than 3 times the upper limit of normal, which can vary by laboratory but is generally below 160 units per liter (U/L) 1. When evaluating lipase levels, it's essential to consider the clinical context, as elevations can occur in various conditions.

• Lipase is an enzyme produced by the pancreas that aids in fat digestion in the small intestine.
• Elevated lipase levels are commonly associated with pancreatic inflammation (pancreatitis), where levels can rise significantly within 24-48 hours of pancreatic injury 1.
• Other conditions that can cause elevated lipase include kidney disease, intestinal obstruction, peptic ulcer disease, and certain medications.
• Low lipase levels are less clinically significant but may occur in conditions like cystic fibrosis or chronic pancreatic damage.
• Lipase testing is often performed alongside amylase testing for a more comprehensive evaluation of pancreatic function, though lipase is generally considered more specific and sensitive for pancreatic disorders 1. Key points to consider when interpreting lipase results include:
• Clinical symptoms and other laboratory findings, as mild elevations can occur in non-pancreatic conditions.
• The timing of lipase level elevation, as it can remain elevated for 8-14 days in cases of pancreatitis.
• The need for confirmation of diagnosis, if required, which can be achieved through computed tomography (CT) of the abdomen using intravenous contrast enhancement 1.

From the Research

Normal Levels of Lipase

The normal levels of lipase can vary depending on the laboratory and the specific assay used.

• According to 2, the optimal diagnostic lipase cutoff of 532 IU/L was determined for diagnosing acute pancreatitis in critically ill patients.
• In 3, it was found that a lipase level of greater than 1000 U/L could discriminate well between patients with and without complications and (or) acute rejection in patients receiving organ transplants.
• The study 4 reported that a serum lipase level > 3 times normal has a sensitivity of 100% and a specificity of 99% in detecting acute pancreatitis.

Variability in Lipase Levels

Lipase levels can be influenced by various factors, including:

• Renal impairment or macrolipase formation, which can cause reduced clearance of lipase 5
• Other hepatobiliary, gastroduodenal, intestinal, and neoplastic causes 5
• Critical illness, including neurosurgical pathology 5
• Alternative pancreatic diagnoses, such as non-pathological pancreatic hyperenzymaemia 5
• Miscellaneous causes, such as diabetes, drugs, and infections 5

Comparison with Amylase

• The study 4 found that serum lipase has a better diagnostic accuracy than serum amylase in differentiating nonpancreatic abdominal pain from acute pancreatitis.
• In 3, it was reported that L2 lipase has the greatest diagnostic efficiency for the diagnosis of pancreatitis, compared with total amylase, P3 amylase, and total lipase.