Serum immunoreactive pancreatic lipase and cationic trypsinogen for the assessment of exocrine pancreatic function in older patients with cystic fibrosis

Cleghorn, Geoffrey, Benjamin, Lynne, Corey, Mary, Forstner, Gordon, Dati, Francesco, & Durie, Peter (1986) Serum immunoreactive pancreatic lipase and cationic trypsinogen for the assessment of exocrine pancreatic function in older patients with cystic fibrosis. Pediatrics, 77(3), pp. 301-306.

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Abstract

Indirect and qualitative tests of pancreatic function are commonly used to screen patients with cystic fibrosis for pancreatic insufficiency. In an attempt to develop a more quantitative assessment, we compared the usefulness of measuring serum pancreatic lipase using a newly developed enzyme-linked immunosorbent immunoassay with that of cationic trypsinogen using a radioimmunoassay in the assessment of exocrine pancreatic function in patients with cystic fibrosis. Previously, we have shown neither lipase nor trypsinogen to be of use in assessing pancreatic function prior to 5 years of age because the majority of patients with cystic fibrosis in early infancy have elevated serum levels regardless of pancreatic function. Therefore, we studied 77 patients with cystic fibrosis older than 5 years of age, 41 with steatorrhea and 36 without steatorrhea. In addition, 28 of 77 patients consented to undergo a quantitative pancreatic stimulation test. There was a significant difference between the steatorrheic and nonsteatorrheic patients with the steatorrheic group having lower lipase and trypsinogen values than the nonsteatorrheic group (P < .001). Sensitivities and specificities in detecting steatorrhea were 95% and 86%, respectively, for lipase and 93% and 92%, respectively, for trypsinogen. No correlations were found between the serum levels of lipase and trypsinogen and their respective duodenal concentrations because of abnormally high serum levels of both enzymes found in some nonsteatorrheic patients. We conclude from this study that both serum lipase and trypsinogen levels accurately detect steatorrhea in patients with cystic fibrosis who are older than 5 years but are imprecise indicators of specific pancreatic exocrine function above the level needed for normal fat absorption.

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27 citations in Web of Science®

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ID Code: 90924
Item Type: Journal Article
Refereed: Yes
Keywords: triacylglycerol lipase, trypsinogen, adult, age, blood and hemopoietic system, child, clinical article, congenital disorder, congenital malformation, cystic fibrosis, diagnosis, digestive system, human, lipid absorption, methodology, pancreas, pancreas function, priority journal, serum, steatorrhea, Adolescent, Cations, Celiac Disease, Child, Preschool, Dietary Fats, Enzyme-Linked Immunosorbent Assay, Feces, Female, Gastrointestinal Contents, Humans, Lipase, Male, Radioimmunoassay, Trypsin
ISSN: 0031-4005
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Copyright Owner: Copyright 1986 by the American Academy of Pediatrics
Deposited On: 02 Dec 2015 04:44
Last Modified: 02 Dec 2015 04:44

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