Serum lipase after secretin stimulation detects mild pancreatic involvement in cystic fibrosis.
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.
Walkowiak
Jaroslaw
J
Department of Gastroenterology, Institute of Pediatrics, Karol Marcinkowski University of Medical Sciences, Poznan, Poland. jarwalk@am.poznan.pl
Nousia-Arvanitakis
Sanda
S
Lisowska
Aleksandra
A
Piotrowski
Robert
R
Strzykala
Krystyna
K
Bychowiec
Bartosz
B
Songin
Tomasz
T
Galli-Tsinopoulou
Assimina
A
Sands
Dorota
D
Pidonia
Ifigenia
I
Krawczynski
Marian
M
Milanowski
Andrzej
A
Herzig
Karl-Heinz
KH
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
D015415:Biomarkers; D008055:Lipids; D012633:Secretin; D008049:Lipase; D010196:Pancreatic Elastase