title: Serum lipase after secretin stimulation detects mild pancreatic involvement in cystic fibrosis.
abstract: BACKGROUND
  The assessment of severe pancreatic insufficiency in cystic fibrosis (CF) is not a diagnostic problem. However, identification of mild cases remains a challenge. The aim of this study was to assess the ability of serum lipase after secretin stimulation to identify mild pancreatic insufficiency in patients with CF.
  
  
  METHODS
  Thirty patients with CF and pancreatic insufficiency (CF-PI) and 30 patients with CF and pancreatic sufficiency (CF-PS) were studied. Thirty healthy subjects with no known gastrointestinal disease served as controls. In all subjects, fecal fat excretion, fecal elastase-1 (E1) concentration and basal and secretin-stimulated serum lipase concentration were measured.
  
  
  RESULTS
  All patients with CF-PI and 3 with CF-PS had abnormally low fecal E1 concentrations. The remaining 27 CF-PS patients and all controls had normal values. Basal and post-stimulation lipase levels were extremely low in patients with CF-PI. Mean basal and poststimulation serum lipase concentrations were significantly higher in CF-PS who had normal fecal E1 concentrations but were still below those of controls (P < 0.001). Among the 27 CF-PS patients with normal fecal elastase, high basal and poststimulation lipase values were found in 6 and 17 patients respectively.
  
  
  CONCLUSIONS
  In patients with CF-PS who have normal fecal elastase-1 concentration, the measurement of basal or secretin-stimulated lipase levels might be helpful in identifying the progression of the destructive process in the pancreas.
authors.affiliation: Department of Gastroenterology, Institute of Pediatrics, Karol Marcinkowski University of Medical Sciences, Poznan, Poland. jarwalk@am.poznan.pl
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Walkowiak
authors.forename: Sanda
authors.initials: S
authors.lastname: Nousia-Arvanitakis
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Lisowska
authors.forename: Robert
authors.initials: R
authors.lastname: Piotrowski
authors.forename: Krystyna
authors.initials: K
authors.lastname: Strzykala
authors.forename: Bartosz
authors.initials: B
authors.lastname: Bychowiec
authors.forename: Tomasz
authors.initials: T
authors.lastname: Songin
authors.forename: Assimina
authors.initials: A
authors.lastname: Galli-Tsinopoulou
authors.forename: Dorota
authors.initials: D
authors.lastname: Sands
authors.forename: Ifigenia
authors.initials: I
authors.lastname: Pidonia
authors.forename: Marian
authors.initials: M
authors.lastname: Krawczynski
authors.forename: Andrzej
authors.initials: A
authors.lastname: Milanowski
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herzig
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D003550:Cystic Fibrosis / Q000150:complications*; D010188:Exocrine Pancreatic Insufficiency / Q000175:diagnosis* / Q000201:enzymology / Q000209:etiology; D005243:Feces / Q000737:chemistry / Q000201:enzymology; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood*; D008055:Lipids / Q000032:analysis; D008297:Male; D010196:Pancreatic Elastase / Q000032:analysis; D012633:Secretin / Q000494:pharmacology; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D008055:Lipids; D012633:Secretin; D008049:Lipase; D010196:Pancreatic Elastase