Formal Name : Serum Amylase

The human body functions like a symphony of biochemical processes, with enzymes taking center stage in maintaining health and diagnosing diseases. Amylase, in particular, is a key enzyme that plays a vital role in carbohydrate metabolism. Its importance goes beyond just digestion, which is why the amylase test is a valuable asset in clinical diagnostics. This article explores the significance of amylase testing, including its indications, methodology, and how to interpret the results.

Why Does Amylase Get Tested?

Amylase testing is mainly performed to assess how well the pancreas is functioning and to identify any related disorders. Changes in amylase levels, whether elevated or decreased, can point to several medical issues, such as:

• Acute pancreatitis:
  • This is one of the primary reasons for the test, as amylase levels can spike significantly during episodes of pancreatic inflammation.
• Chronic pancreatitis:
  • Consistently abnormal amylase levels may indicate ongoing damage to the pancreas.
• Salivary gland disorders:
  • Conditions such as mumps or blockages in the salivary ducts can influence amylase levels.
• Other conditions:
  • Issues like gastrointestinal perforations, infections, or kidney problems can also lead to changes in amylase levels.

When to Get the Test?

A healthcare provider may suggest an amylase test if a patient shows symptoms like:

• Intense abdominal pain, particularly in the upper abdomen.
• Ongoing nausea and vomiting.
• Unexplained fever accompanied by abdominal discomfort.
• Swelling and tenderness in the abdominal area.

These symptoms frequently indicate potential pancreatic or gastrointestinal problems, making an amylase test necessary for further evaluation.

Sample Required for the Test

The amylase test usually involves taking a blood sample from a vein in the arm. In certain situations, a urine sample might also be collected to assess urinary amylase levels, especially when tracking ongoing conditions or after treatment.

Test Preparation

The amylase test typically needs little preparation. However, taking some precautions can help ensure accurate results:

• Fasting:
  • Some healthcare providers may recommend fasting for 8-12 hours prior to the test.
• Medication Disclosure:
  • It’s important to inform your doctor about any medications you are taking, including over-the-counter drugs and supplements, since some can affect amylase levels (for example, aspirin, birth control pills, and corticosteroids).

Reference Ranges of the Test

The normal reference range for amylase levels can vary slightly based on the laboratory and the method used for measurement. Generally, the ranges are as follows:

• Blood Amylase: 30 to 110 U/L (units per liter)
• Urinary Amylase: 2 to 20 U/h (units per hour)

Values that fall outside these ranges may suggest potential health concerns and should be assessed further.

1. In International Units (U/L)

• Newborns: 5–65 U/L
• Infants and Children: 8–80 U/L
• Adults (both genders): 30–110 U/L
• Note: The upper limits may be slightly higher in women, especially during pregnancy.

2. In SI Units (µkat/L)

• Newborns: 0.08–1.08 µkat/L
• Infants and Children: 0.13–1.33 µkat/L
• Adults: 0.50–1.85 µkat/L

3. In Somogyi Units

• This measurement is rarely used but can range from 2–23 Somogyi units per 100 mL for adults.

4. Factors Influencing Ranges

• Age:
  • Newborns and infants typically exhibit lower levels because of their immature pancreatic function.
• Gender:
  • There are no major differences between genders, although variations can arise from hormonal changes, such as during pregnancy.
• Ethnicity and Population:
  • There may be slight variations influenced by genetic and dietary factors.
• Clinical Context:
  • Serum amylase levels can rise in conditions like pancreatitis, mumps, or renal failure. Conversely, decreased levels might be seen in chronic pancreatitis or pancreatic insufficiency.

What is Being Tested?

The amylase test assesses the activity of the enzyme in either blood or urine. Amylase is mainly produced by the pancreas and salivary glands, and it is essential for breaking down starch into simpler sugars. The level of amylase in the bloodstream indicates how much is being produced and cleared by the body, making it a useful marker for the health of the pancreas and salivary glands.

Interpretation of Abnormal Results

• Elevated Levels:
  • Acute Pancreatitis: Levels can be 4-6 times higher than normal.
  • Pancreatic Pseudocyst: This condition indicates the presence of fluid-filled sacs in the pancreas.
  • Salivary Gland Infections: Includes illnesses such as mumps or sialadenitis.
  • Renal Failure: Impaired kidney function may result in decreased clearance.
• Decreased Levels:
  • Chronic Pancreatitis: Long-term damage to the pancreas leads to reduced enzyme production.
  • Cystic Fibrosis: A genetic disorder that affects mucus production, which in turn impacts pancreatic function.
  • Severe Pancreatic Damage: Refers to advanced conditions where the pancreas loses its ability to function properly.

Common Questions

Q: Can medications affect amylase levels?

A: Yes, some medications, including diuretics, opiates, and chemotherapy drugs, can affect amylase levels. It’s important to inform your doctor about any medications you are taking.

Q: Is fasting always required for the test?

A: Fasting isn’t necessary for all patients, but it may be suggested for more accurate results.

Q: What other tests are often done alongside the amylase test?

A: The lipase test is commonly performed with the amylase test to give a more complete assessment of pancreatic function.

Q: Can lifestyle factors influence amylase levels?

A: Yes, heavy alcohol use and smoking can affect pancreatic health, which in turn can change amylase levels.