What is alpha amylase (pancreatic)?
Alpha-amylase is one of the enzymes of the digestive system, synthesized mainly by cells of the pancreas of the exocrine type and is responsible for the breakdown of complex carbohydrate components of food, starch and glycogen to simple carbohydrates (glucose). This enzyme is produced in small quantities by the salivary glands as part of saliva. Normally, a minimal amount of alpha-amylase enters the general bloodstream, since the pancreas has a very good blood supply. Passing through the kidneys, the enzyme is excreted in the urine.
In this regard, in laboratory diagnostics, two diagnostic studies of the enzymatic activity of this class of amylase are used:
- Blood alpha-amylase;
- Urine diastasis (urine amylase).
Amylase content in blood
In every laboratory that conducts a blood test for the level of alpha-amylase, there are certain standards for this indicator. Therefore, in the form next to the result obtained, the norm is indicated, taking into account the units of measurement and the reagents used to determine it. Most often they are guided by such standards:
- When measuring the activity of alpha-amylase in μcatal / l - 16-30;
- When measuring the activity of alpha-amylase in U / l - 20-100;
The norm in women
Despite the differences in biochemical processes in the male and female bodies, no significant differences in the amylase activity of blood are determined in laboratory research. Therefore, the average rates of blood amylase have such a wide range. It is common to both males and females.
Why is amylase elevated in the blood?
An increase in the concentration of alpha-amylase in the blood (hyperamilasemia) in most cases is based on pathological processes in the pancreas and damage to organs located next to it. The mechanism of this pathological condition can be explained by the increased release of amylase from the cells of the pancreas into the systemic circulation.
This can happen under the following circumstances:
- Excessive secretion of pancreatic juice;
- Obstruction of the full outflow of pancreatic secretion along the excretory ducts into the duodenum;
- Inflammatory changes in the pancreas or nearby organs. In this case, an increase in blood flow occurs, which ends with an increased release of enzymes into the blood;
- Traumatic or necrotic destruction of pancreatic tissue;
Such pathogenetic mechanisms underlie conditions:
- Acute pancreatitis;
- Chronic pancreatitis in the acute stage;
- Focal pancreatic necrosis (local self-digestion of the pancreas);
- Cancer tumors of any part of the pancreas, first of all, its head;
- Gallstone disease, especially with the presence of stones in the duct system;
- Tumors and wedged stones of the Vater's nipple of the duodenum, where the excretory pancreatic duct opens;
- Mumps virus;
Important to remember! A slight increase in amylase is when its numbers are several units of measurement higher than the norm. If a person's well-being is not disturbed, this does not mean pathology. Alert should be an excess of the norm by 2 or more times. This version of the results obtained almost always speaks of the pathology of the pancreas.
Why is amylase low in blood?
In general, if blood amylase tends to zero, this is a normal state, which indicates the ability of the pancreas to keep this enzyme under control. But in practice, this does not happen. In each person, when examining amylase, a certain amount of it in the composition of the plasma will be revealed. If the resulting indicator is much less than the lower limit of the norm, then this indicates that the enzymatic activity of the pancreas is sharply reduced.
This can be with diseases:
- Total pancreatic necrosis (complete self-digestion of the pancreas);
Malignant tumors of the pancreas are stage 4, when the normal glandular tissue of the organ is replaced by tumor;
- Cystic fibrosis - congenital fermentopathy;
- Pancreas surgeries in which most of the organ is removed.
Amylase content in urine
Amylase, which is found in urine, is called diastase. Its activity is several times higher than that of blood amylases. This can be explained by the fact that amylase is in a more diluted state in the blood. Passing through the kidneys, it is concentrated in a small volume of urine. Therefore, its definition is used more often. Moreover, for the analysis you just need to collect urine. The only thing to remember is the possibility of increasing diastasis, not only in connection with the pathology of the pancreas.
The established laboratory diastase norms are as follows:
- In U / L - up to 1000;
- In mkatal / l - 28-100.
Why is urine amylase elevated?
All conditions that are accompanied by an increase in blood amylase automatically cause an increase in urine diastase.
It can be:
- Acute and chronic pancreatitis;
- Pancreatic necrosis;
- Pancreatic tumors;
- Any form of gallstone disease and hepatitis;
- Diet and alcohol abuse. The most dangerous combination of these factors;
- Acute pathology of internal organs of a surgical nature (appendicitis, destructive cholecystitis, intestinal obstruction, perforated ulcer);
- Ectopic pregnancy.
Important to remember! A slight increase in urine diastase can indicate either minor deviations in the work of the pancreas, or diseases of organs that are in anatomical proximity to the pancreas. Exceeding the norm by two or more times is always pancreatic problems.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".