Skip to main content
SpringerLink
Log in

Lipase/amylase ratio distinguishes mild acute biliary pancreatitis from nonpancreatitis

  • Research Article
  • Published:
Central European Journal of Medicine

Abstract

The report by Gumaste et al. [Gastroenterology 1991;101:1361–1366] that the lipase/amylase ratio (Lip/Amy) could be a new index distinguishing acute episodes of alcoholic (Lip/Amy >2) from nonalcoholic pancreatitis (Lip/Amy <2), with the critical value being Lip/Amy =2, has been followed by some debate between supporters and opponents. By comparing the Lip/Amy in a group of 16 carefully selected patients with mild acute gallstone-related (biliary) pancreatitis with that in a reference group of 44 controls, this study examines whether or not this ratio could be a useful index for diagnosing biliary pancreatitis. Considering that both pancreatic and hepatobiliary systems are blocked by stones, hepatic biochemical parameters such as serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and total bilirubin (TB) were also included in fitting the regression equation. The average value of Lip/Amy in the biliary pancreatitis group was 2.29 ± 0.93, while that in the control group was 1.30 ± 0.99. Thus, Lip/Amy was found to be a significant index for distinguishing mild acute biliary pancreatitis from nonpancreatitis. However, the critical value of Lip/Amy seemed to depend on the diet pattern and cultural background.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lankisch PG, Burchard-Reckerts S, Lehnick D. Underestimation of acute pancreatitis: patients with only a small increase in amylase/lipase levels can also have or develop severe acute pancreatitis. Gut, 1999, 44, 542–544

    Article  PubMed  CAS  Google Scholar 

  2. Butler J, Mackway-Jones K. Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. Serum amylase or lipase to diagnose pancreatitis in patients presenting with abdominal pain. Emerg. Med. J., 2002, 19, 430–431

    Article  PubMed  Google Scholar 

  3. Gumaste V.V., Dave P.B., Weissman D., Messer J. Lipase/amylase ratio. A new index that distinguishes acute episodes of alcoholic from nonalcoholic acute pancreatitis. Gastroenterology, 1991, 101, 1361–1366

    PubMed  CAS  Google Scholar 

  4. Tenner S.M., Steinberg W. The admission serum lipase: amylase ratio differentiates alcoholic from nonalcoholic acute pancreatitis. Am. J. Gastroenterol., 1992, 87, 1755–1758

    PubMed  CAS  Google Scholar 

  5. Stimac D., Rubinić M., Lenac T., Kovac D., Vcev A., Miletic D. Biochemical parameters in the early differentiation of the etiology of acute pancreatitis. Am. J. Gastroenterol., 1996, 91, 2355–2359

    PubMed  CAS  Google Scholar 

  6. Stimac D., Lenac T., Marusić Z. A scoring system for early differentiation of the etiology of acute pancreatitis. Scan. J. Gastroenterol., 1998, 33, 209–211

    Article  CAS  Google Scholar 

  7. Pacheco R.C., Oliveira L.C. Lipase/amylase ratio in biliary acute pancreatitis and alcoholic acute/acutized chronic pancreatitis. Arq. Gastroenterol., 2007, 44, 35–38

    Article  PubMed  Google Scholar 

  8. Ansari E., Talenti D.A., Scopelliti J.A., Saadat J.M., Zehr B.D. Serum lipase and amylase ratio in acute alcoholic and nonalcoholic pancreatitis by using Dupont ACA discrete clinical analyzer. Dig.Dis.Sci., 1996, 41, 1823–1827

    Article  PubMed  CAS  Google Scholar 

  9. Pezzilli R., Billi P., Miglioli M., Gullo L. Serum amylase and lipase concentration and lipase/amylase ratio in assessment of etiology and severity of acute pancreatitis. Dig. Dis. Sci., 1993, 38, 1265–1269

    Article  PubMed  CAS  Google Scholar 

  10. Lankisch P.G., Petersen M. Lipase/amylase ratio: not helpful in the early etiological differentiation of acute pancreatitis. Z. Gastroenterol., 1994, 32, 8–11

    PubMed  CAS  Google Scholar 

  11. Jaakkola M., Sillanaukee P., Löf K., Koivula T., Nordback I. Blood tests for detection of alcoholic cause of acute pancreatitis. Lancet., 1994, 343, 1328–1329

    Article  PubMed  CAS  Google Scholar 

  12. King L.G., Seelig C.B., Ranney J.E. The lipase to amylase ratio in acute pancreatitis. Am. J. Gastroenterol., 1995, 90, 67–69

    PubMed  CAS  Google Scholar 

  13. Mannes G., Rabitti P.G., Laccetti M., Pacelli L., Carruturo I., Uomo G. Early prediction of aetiology and severity of acute pancreatitis by serum amylase and lipase assays. Minerva Gastroenterol. Dietol., 1995, 41, 211–215

    Google Scholar 

  14. Luengo L., Castellote M., Ros S., Feliu F., Vadillo J., Olona C. Clinical usefulness of the determination of the lipase/elastase ratio and of the polymorphonuclear elastase in the hospital admission of the patient with acute pancreatitis. Rev. Esp. Enferm. Dig., 1996, 88, 551–554

    PubMed  CAS  Google Scholar 

  15. Tourné I., Viedma J.A., Pérez-Mateo M. Biochemical model of logistic regression for early prediction of the etiology of acute pancreatitis. Rev. Esp. Enferm. Dig., 1997, 89, 885–896

    PubMed  Google Scholar 

  16. Pezzilli R., Billi P., Barakat B., Miglio F. Lipaseamylase ratio does not determine the etiology of acute pancreatitis. Another myth bites the dust. J. Clin. Gastroenterol., 1998, 26, 34–38

    Article  PubMed  CAS  Google Scholar 

  17. Pezzilli R, Fantini L. Lipase/amylase ratio and liver function tests for the etiological assessments of acute pancreatitis: facts and fiction. Recenti. Prog. Med., 2006, 97, 477–480

    PubMed  Google Scholar 

  18. Wang S.S., Lin X.Z., Tsai Y.T., et al. Clinical significance of ultrasonography, computed tomography, and biochemical tests in the rapid diagnosis of gallstone-related pancreatitis: a prospective study. Pancreas., 1988, 3, 153–158

    Article  PubMed  CAS  Google Scholar 

  19. Ranson J.H.C., Rifkind K.M., Turner J.W. Prognostic signs and non-operative peritoneal lavage in acute pancreatitis. Surg. Gynecol. Obstet., 1976, 143, 209–219

    PubMed  CAS  Google Scholar 

  20. Imrie C.W., Benjamin I.S., Ferguson J.E., et al. A single-center double-blind trial of trasylol therapy in primary acute pancreatitis. Br. J. Surg., 1978, 68, 337–341

    Article  Google Scholar 

  21. Bradley E.L. A clinically based classification system for acute pancreatitis: summary of the International Symposium on Acute Pancreatitis, Atlanta, September 11–13, 1992. Arch. Surg., 1993, 128, 586–590

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Catholic University of Daegu, Daegu, 712-702, Republic of Korea

    Joon Hyuck Choi

  2. Department of Nano Medical Engineering, Pusan National University, Miryang, 627-706, Republic of Korea

    Nam Lyong Kang

  3. Statistical and Biophysical Laboratory, Department of Physics, Kyungpook National University, Daegu, 702-701, Republic of Korea

    Sang Don Choi

Authors
  1. Joon Hyuck Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nam Lyong Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sang Don Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nam Lyong Kang.

About this article

Cite this article

Choi, J.H., Kang, N.L. & Choi, S.D. Lipase/amylase ratio distinguishes mild acute biliary pancreatitis from nonpancreatitis. cent.eur.j.med 4, 293–298 (2009). https://doi.org/10.2478/s11536-009-0039-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2478/s11536-009-0039-0

Keywords

Search

Navigation