Serum Lipase / Amylase Ratio in Assessment of Etiology and Severity of Acute Pancreatitis

Hyun, Jin Hae; Lee, Sang Woo; song, Chi Wook; Ryu, Ho Sang; Kim, Chang Duck; Jeen, Yoon Tae; Kim, Kwang Hee; Lee, Hong Sik; Lee, Sung Joon; Park, Heung Jin; Chun, Hoon Jai; Um, Soon Ho; Choi, Jai Hyun; Kim, Seung Joo

Abstract

BACKGROUND AND AIMS: The usefulness of serum pancreatic enzyme deterrninations in the diagnosis of acute pancreatitis is well established. There are differences between clinical course and outcome due to the underlying etiological factors in acute pancreatitis. In this study we assess the ability of the serurn lipase/amylase ratio to differentiate the etiologies and to predict the severity of it.
METHODS
We evaluated retrospectively the records of 104 patients (M:64, F:40) with acute pancreatitis. The diagnosis of acute pancreatitis was based on the typical symptoms, signs, pancreatic enzyme elevation and radiological findings. Ranson, Glasgow and APACHE II at admission were used for grading of clinical severity. The patients were classified into four etiologic groups: alcohol, gallstone, idiopathic and others.
RESULTS
The ratio of underlying cause of acute pancreatitis were as follows: alcohol, 35.6%; gallstone, 27.9%; idiopathic, 22.1%; others, 14.4%. There were no differences in the serum amylase, lipase and lipase/amylase ratio among the etiological groups. The clinical severities of pancreatitis according to the Ranson, Glasgow and APACHE II were not related with the lipase/amylase ratio in pancreatitis.
CONCLUSIONS
Evaluation of serum lipase/amylase ratio is not useful for assessing etiology and severity of acute pancreatitis.