3.  Amylase:
 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.

4.  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.

5.  Macroamylasemia is a condition characterized
by persistent elevation of serum amylase
activity with no apparent clinical symptoms of
pancreatic disease.
 Amylase complexes with immunoglobulins,
which prevents renal excretion.
 Macroamylasemia by itself is not a disease,
but it may be an early marker of pancreatic
disease.

6.  The increased renal clearance of amylase is
reflected in increase levels of amylase in
urine.
 Urinary amylase is more sensitive indicator
than serum amylase.

7.  Acute pancreatitis
 Diabetic ketoacidosis
 Burns
 Renal failure
 Perforated duodenal ulcer
 Malignancy
 Gall stones
 Ovarian cysts.

8.  Lipase:
 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.

9.  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.

10.  Therefore lipase estimation has advantage
over amylase estimation.
 Serum lipase levels are elevated in:
 Pancreatitis
 Peptic ulcer
 Malignancy
 Renal failure
 Salivary gland inflammation

11.  Text book of Biochemistry – DM Vasudevan
 Text book of Biochemistry – U Satyanarayana
 Text book of Biochemistry – MN Chatterjea