Lipase

Lipase is an enzyme secreted by the pancreas into the intestine to digest dietary fats. Blood levels are low, but lipase rises sharply when the pancreas becomes inflamed. It is therefore the main laboratory test for suspected acute pancreatic inflammation (acute pancreatitis), often alongside amylase.

Who is this test for

• people with upper abdominal pain, often radiating to the back, with nausea and vomiting, when pancreatic inflammation is suspected;
• people after acute pancreatitis and those with recurrent pancreatic inflammation;
• people with gallstones or high alcohol intake and symptoms suggesting a pancreatic problem;
• people having a comprehensive check-up, alongside amylase and liver tests.

What lipase is and what it shows

Lipase breaks down fats (triglycerides) in the digestive system. Blood lipase comes mainly from the pancreas, making it more specific for pancreatic disease than amylase, which is also produced by salivary glands.

In acute pancreatitis, lipase rises within a few hours of pain onset and remains elevated longer than amylase, usually 8 to 14 days. It is therefore useful even when a patient sees a doctor several days after symptoms begin. The most common causes of pancreatitis are gallstones and heavy alcohol consumption.

Severe abdominal pain: when to seek urgent medical attention

Acute pancreatitis is treated in hospital. If you have severe, constant upper abdominal pain, particularly with vomiting, fever, yellow skin or eyes, or marked weakness, do not wait for laboratory results; seek emergency medical care immediately. Laboratory lipase testing does not replace emergency examination.

Preparation and sample

Lipase is measured in venous blood. Fasting is not essential for this test alone, but if glucose or blood lipids are also measured, come fasting in the morning. Tell your doctor which medicines you take, because some, such as opioid painkillers, may affect the result.

How results are interpreted

Lipase is expressed in U/L. The reference interval depends on the method and is printed on the report. A doctor interprets it alongside symptoms, examination and other tests.

Lipase and acute pancreatitis

Diagnosing acute pancreatitis requires two of three criteria: typical abdominal pain, lipase or amylase at least three times the upper reference limit, and signs of pancreatic inflammation on imaging such as CT. The lipase level does not show how severe the inflammation is, so disease severity is assessed using other markers.

Other causes of elevated lipase

Mildly elevated lipase, less than three times the upper limit, more often has other causes: impaired kidney function (more about creatinine), gallbladder inflammation, bowel obstruction, a perforated ulcer, impaired intestinal blood supply, diabetic ketoacidosis or coeliac disease. Rarely, it is a harmless phenomenon in which lipase binds to antibodies in blood and is eliminated more slowly (macrolipase).

Chronic pancreatitis and pancreatic cancer

In chronic pancreatitis, lipase is often normal and may be low when the pancreas has been damaged for a long time. Lipase is not a pancreatic cancer detection test, and normal results do not exclude a tumour. Signs to look out for are described in the article on early signs of pancreatic cancer.

How to arrange testing

You can come for blood collection without an appointment or referral at one of our branches throughout Croatia (listed on the Contactpage). Prices for all tests and panels are listed in the service price list. Amylase is often measured alongside lipase, so both tests can be performed from the same blood collection.

Frequently asked questions

What does elevated blood lipase mean?

Lipase more than three times the upper limit with abdominal pain most often suggests acute pancreatitis. Mildly elevated lipase without typical symptoms more often results from other conditions, such as impaired kidney function, so a doctor interprets it alongside examination and other tests.

Is lipase or amylase better?

Lipase is more reliable for acute pancreatitis because it comes mainly from the pancreas and remains elevated longer. Amylase is still often measured alongside it and is also useful in salivary gland disease.

How long does lipase remain elevated after pancreatitis?

It usually returns within the reference interval in one to two weeks. If it remains elevated longer or rises again, a doctor looks for a cause, such as a complication or recurrent inflammation.

What does low lipase mean?

Low lipase rarely has particular significance. With long-term pancreatic damage, for example chronic pancreatitis or cystic fibrosis, it may be reduced, but a doctor uses other tests to assess pancreatic digestive function.