title: Elevated serum lipase levels in patients with dyspepsia of unknown cause in general practice.
abstract: OBJECTIVE
  To study the cause(s) of chronic dyspepsia among patients with no findings on general practice screening tests.
  
  
  METHODS
  A total of 272 consecutive patients at a general practice in Japan (125 males and 147 females, aged 14-89 years) who underwent abdominal ultrasound (US) and who had serum pancreatic enzyme (lipase or p-amylase) levels measured, were included in a 1-year study. Serum pancreatic enzyme levels were compared according to the duration of the symptoms and causes of dyspepsia, and then compared between two groups: a 'known-cause group' of 38 patients in whom the cause of the chronic (over 1 month) dyspepsia was determined by US or other diagnostic procedures; and an 'unknown-cause group' of 112 patients in whom no cause was found.
  
  
  RESULTS
  The mean lipase level in the unknown-cause group was significantly higher than that in the known-cause group (40.6 vs. 35.3 U/l, p = 0.008 after adjustment for age, sex, and serum creatinine). No difference between these groups was found for p-amylase. The proportion of patients with high lipase levels (above reference range) was higher in the unknown-cause group compared to the known-cause group, although this was not significant (21.4 vs. 10.5%).
  
  
  CONCLUSIONS
  Our data showed that serum lipase levels were higher in patients with chronic dyspepsia of unknown than in those with a known cause. We therefore speculate that mild functional pancreatic disorder may underlie some cases with unexplainable chronic dyspepsia.
authors.affiliation: Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan. rieokada@med.nagoya-u.ac.jp
authors.forename: Rieko
authors.initials: R
authors.lastname: Okada
authors.forename: Akira
authors.initials: A
authors.lastname: Okada
authors.forename: Takashi
authors.initials: T
authors.lastname: Okada
authors.forename: Tohru
authors.initials: T
authors.lastname: Okada
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Hamajima
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004415:Dyspepsia / Q000503:physiopathology*; D005194:Family Practice; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D008049:Lipase