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Pancreatic enzymes (lipase, amylase, elastase) are produced by the exocrine pancreas. The examination of the level of their activity is performed, among others, by at suspicion of diseases of the pancreas and other organs of the digestive system. If pancreatic enzymes are elevated or lowered, you can be sure that the pancreas is not working properly. Find out what the standards for pancreatic enzymes are and how to interpret test results.

Pancreatic enzymes( lipase ,amylase ,elastase) are substances that are found in pancreatic juice produced by the exocrine pancreas. They go to the duodenum, where they are responsible for digestion and breakdown of nutrients: carbohydrates, proteins and fats.

The production of pancreatic enzymes is strictly controlled by the hormones of the digestive system, such as while stretching the stomach or digesting in the higher parts of the digestive tract. If the control process is disrupted, there can be over- or under-production of enzymes that may indicate a variety of medical conditions, not just the pancreas.

Pancreatic enzymes - amylase. Standards

Amylase is one of the most important and active pancreatic enzymes. It is the only one responsible for digesting carbohydrates - breaking down polysaccharides into simple sugars. This process takes place in the mouth, duodenum and small intestine. (amylase is also produced by the salivary glands, the mucosa of the small intestine, as well as by the mammary glands, testes and ovaries). The level of pancreatic amylase in the body can be determined by a blood or urine test (as it is also excreted with it).

  • the correct concentration of amylasein urine is10-490 U / Iand in blood25-125 U / I , but in older people it is slightly higher -20-160 U / l .

Increased amylase levelsmay be due to, inter alia, about acute pancreatitis or chronic pancreatitis, cholecystitis, gastric or duodenal ulcer perforation, mumps, liver disease, kidney failure, alcoholism, and even ectopic pregnancy.

In turndecreased amylase levelsmay suggest extensive damage to the pancreas (e.g. acute fulminant inflammationpancreas, advanced chronic pancreatitis), cystic fibrosis, severe liver damage (e.g. hepatitis). Its activity is also reduced by drugs that bind calcium (e.g. citrates and oxalates).

Pancreatic enzymes - lipase. Standards

Pancreatic lipaseis a representative of enzymes that break down fats, specifically food triglycerides into fatty acids and glycerol. The lipase produced by the pancreas is inactive. Only after reaching the duodenum, it transforms into its active form (ready for digestion) under the influence of bile acids, phospholipids and protein - collipase. Lipase does not pass into the urine, therefore its activity can only be assessed by blood tests.

  • normalblood lipase concentrationshould not exceed the level of 150.0 U / L.

Elevated levels of pancreatic lipasemay be due to, inter alia, about acute pancreatitis or cancer of this organ, perforation of a duodenal ulcer, peritonitis, as well as obstruction of the pancreatic duct. Medicines, e.g. codeine, heparin, opioids, also contribute to increasing the level of pancreatic lipase activity.

Other pancreatic enzymes that digest fats arephospholipaseandesterase .

Pancreatic enzymes - elastase. Standards

Elastase is a representative of the enzymes that break down food protein into smaller particles called peptides. Elastase passes through the pancreatic juice into the intestines and is then excreted in the faeces. Due to the fact that elastase itself is not digested in the gastrointestinal tract, its content in the stool closely corresponds to the amount secreted by the pancreas.

Fecal elastase-Correct level :>200ug / g feces

Reduced levels of elastase usually indicate inflammation or insufficiency of the pancreas leading to malabsorption. Therefore, testing the level of elastase is a very important prophylactic test in people at increased risk of developing, e.g. diabetes.

Another pancreatic enzyme that digests proteins istrypsinogen . The inactive enzyme is produced by the pancreas and then transported to the small intestine, where, with the help of an enzyme in the intestinal mucosa, it is transformed into the active form -trypsin .

Standards for this enzyme have not been established as they depend on many factors such as age, gender, and assay method. Therefore, the results presented as numerical values ​​have different meanings in different laboratories. The final interpretation of the test results is therefore up to the doctor.

However, it is important to know that elevated levels can indicate cystic fibrosis in an infant, as well as impaired pancreatic enzyme secretion, pancreatitis, or pancreatic cancer in adults or infants.

Other pancreatic enzymes that digest proteins arechymotrypsinandcarboxypeptidase .

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