Preferences help
enabled [disable] Abstract
Number of results
2009 | 4 | 3 | 293-298
Article title

Lipase/amylase ratio distinguishes mild acute biliary pancreatitis from nonpancreatitis

Title variants
Languages of publication
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.
Physical description
1 - 9 - 2009
3 - 7 - 2009
  • Department of Internal Medicine, Catholic University of Daegu, Daegu, 712-702, Republic of Korea
  • Department of Nano Medical Engineering, Pusan National University, Miryang, 627-706, Republic of Korea
  • Statistical and Biophysical Laboratory, Department of Physics, Kyungpook National University, Daegu, 702-701, Republic of Korea
  • [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[Crossref]
  • [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[Crossref]
  • [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
  • [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
  • [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
  • [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[Crossref]
  • [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[Crossref]
  • [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[Crossref]
  • [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[Crossref]
  • [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
  • [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[Crossref]
  • [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
  • [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
  • [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
  • [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
  • [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[Crossref]
  • [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
  • [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[Crossref]
  • [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
  • [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[Crossref]
  • [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
Document Type
Publication order reference
YADDA identifier
JavaScript is turned off in your web browser. Turn it on to take full advantage of this site, then refresh the page.