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[Biochemistry](https://durgical.com/en/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](https://durgical.com/en/conditions/acute-pancreatitis/)
- [Chronic pancreatitis](https://durgical.com/en/conditions/chronic-pancreatitis/)
- [Pancreatic cancer](https://durgical.com/en/conditions/pancreatic-cancer/)
- [Familial chylomicronemia syndrome (lipoprotein lipase deficiency)](https://durgical.com/en/conditions/familial-chylomicronemia-syndrome/)
- [Chronic kidney disease](https://durgical.com/en/conditions/chronic-kidney-disease/)

## Related

- [Amylase as a lab test](https://durgical.com/en/biochemistry/topics/amylase-as-a-lab-test/)
- [Lipoprotein lipase (LPL)](https://durgical.com/en/biochemistry/enzymes/lipoprotein-lipase/)
- [Hormone-sensitive lipase (HSL)](https://durgical.com/en/biochemistry/enzymes/hormone-sensitive-lipase/)

## 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.

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Educational information, not medical advice. For any symptom, see a health professional.

Sources: [Lipase Tests: MedlinePlus Medical Test](https://medlineplus.gov/lab-tests/lipase-tests/) (MedlinePlus, US National Library of Medicine, 2026); [Lipase test: MedlinePlus Medical Encyclopedia](https://medlineplus.gov/ency/article/003465.htm) (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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