Biochemistry · Topic
Lipase as a lab test !
Pancreatic lipase is the preferred marker of acute pancreatitis: more specific than amylase and high for more days.
Updated 2026-11-01
Key facts
- It hydrolyses triglycerides in the gut lumen (with colipase and bile salts) to release fatty acids and monoglycerides.
- In acute pancreatitis it rises in 4–8 hours, peaks at 24 h and stays high for 8–14 days.
- Values above 3 times the laboratory's upper limit, with typical pain, support the diagnosis of pancreatitis.
- Like amylase, its level does not track severity and is not used to follow progress.
- It is different from endothelial lipoprotein lipase and from hormone-sensitive lipase of fat cells.
In detail
- What it measures: lipase activity (or mass) in serum.
- Where it comes from: almost all from pancreatic acinar cells; small amounts from stomach, bowel and tongue (lingual lipase in infants).
- Why it rises: acute pancreatitis (gallstones, alcohol, hypertriglyceridaemia, hypercalcaemia, drugs, after ERCP), pancreatic duct obstruction, pancreatic tumours, bowel perforation, renal failure (lower clearance), diabetic ketoacidosis.
- Pitfalls: mild rises in kidney disease, coeliac disease and bowel inflammation without pancreatitis; in advanced chronic pancreatitis it may be normal because little acinar tissue remains.
- Hypertriglyceridaemic pancreatitis occurs with very high triglycerides; pancreatic lipase releases free fatty acids that injure the gland.
- Also called
- Serum lipase, Pancreatic lipase
Clinical notes
- With epigastric pain radiating to the back and lipase above three times the limit, pancreatitis is established and CT is kept for doubt or complications.
- Repeating lipase daily adds nothing: progress is followed by the clinical picture, organ failure and markers such as CRP.
- In chronic pancreatitis faecal elastase is used to assess exocrine function, not serum lipase.
Related conditions
- Acute pancreatitis
- Chronic pancreatitis
- Pancreatic cancer
- Familial chylomicronemia syndrome (lipoprotein lipase deficiency)
- Chronic kidney disease
Related
Test yourself
Think of the answer, then tap the question to see it.
Why is lipase more useful than amylase for acute pancreatitis?
It is almost exclusive to the pancreas and stays high longer, so it also diagnoses late presenters.
Which threshold supports a diagnosis of acute pancreatitis?
A lipase (or amylase) above three times the laboratory's upper limit, with typical pain or matching imaging.
Why can lipase be normal in advanced chronic pancreatitis?
Because fibrosis has destroyed much of the acinar tissue that makes it.
What does pancreatic lipase need to act on fats?
Colipase and bile salts, which form micelles and let it bind the lipid–water interface.
Educational information, not medical advice. For any symptom, see a health professional.
Sources: Lipase Tests: MedlinePlus Medical Test (MedlinePlus, US National Library of Medicine, 2026); Lipase test: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2026); Textbook of Biochemistry for Medical Students, 6th ed. (Jaypee Brothers Medical Publishers (Vasudevan DM, Sreekumari S, Vaidyanathan K), 2011).
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Representative model, for educational purposes only.