Normal amylase serum level is 50-120 IU/L
Digests starch & glycogen in the diet.
The hydrolytic products are maltose,
maltotriose & dextrins.
The brush border enzymes complete
hydrolysis to give glucose.
Amylase particularly useful in diagnosis of
acute pancreatitis, the sensitivity is 75 %.
It starts rising in the serum within few hrs of
onset of disease, reaches a peak in 24 hrs &
returns to normal in three to five days with
increased renal clearance.
Macroamylasemia is a condition characterized
by persistent elevation of serum amylase
activity with no apparent clinical symptoms of
Amylase complexes with immunoglobulins,
which prevents renal excretion.
Macroamylasemia by itself is not a disease,
but it may be an early marker of pancreatic
The increased renal clearance of amylase is
reflected in increase levels of amylase in
Urinary amylase is more sensitive indicator
than serum amylase.
Normal lipase levels: 50-175 IU/L.
The most important is salivary, pancreatic,
gastric lipase for fat digestion.
Pancreatic lipase digests a triglyceride to two
fatty acids & a monoglyceride.
The first line laboratory tests include
estimation of serum levels of pancreatic
lipase & amylase.
Most pancreatic disease remain clinically
silent until 90% of gland is destroyed.
The acute pancreatitis lipase levels are very
high (2 -5 times the normal amount).
There is a rapid rise of lipase level in blood
after attack & persists for 7 - 14 days.
Sensitivity of amylase & lipase for detection
of acute pancreatitis is 91 & 94% respectively.