Alpha amylase: normal, in blood, urine, increased,lowered

Update: November 2018

The study of alpha amylase doctors prescribe mainly for
diagnosis of pancreatitis. However, this analysis can give valuable
information in the case of other diseases. What does the increase show
α-amylase in the blood or urine? Do I need to worry if this
figure goes beyond the norm, and there are no symptoms?

What is α-amylase

It is an enzyme that breaks down and helps digest complex
carbohydrates – glycogen and starch (“amylon” translated from Greek –
starch). It is produced mainly by exocrine glands –
salivary and pancreatic, a small amount is produced
glands of the ovaries, fallopian tubes and lungs. Bulk of this
enzyme is found in the digestive juices: in saliva and
pancreatic secretion. But a slight concentration is present in
serum, as the cells of any organs and tissues are constantly
are updated.

The blood contains two fractions of α-amylase:

  • pancreatic (P-fraction) – 40% of total amylase;
  • salivary (S – type) – 60%.

Альфа амилазаHowever, the study of individual fractions of amylase
rarely, only by special indications. More often
enough to determine the total amylase. In combination with clinical
her symptoms increase her confirms the diagnosis of acute
pancreatitis.

This is the most common indication for this analysis.
Amylase in this case will be enhanced precisely by
pancreatic fraction. Its molecule is small and well filtered.
through the renal tubules, so with an increase in its content in
blood, it will be increased in the urine (alpha amylase in the urine taken
called diastase).

The rate of amylase content

Enzymes are proteins that catalyze the breakdown
any complex substances. Their activity is usually measured in IU
(international units). For 1 IU of enzyme activity is taken
its amount that catalyzes the splitting of 1 µmol
substances for 1 minute under standard conditions.

As a cleavable substrate in determining the activity
amylase used to use starch, iodine as an indicator
(which, as you know, stains starch blue). Less than
intense coloring of the substrate after interacting it with
the studied serum – the greater the activity of amylase in it.

Now used modern spectrophotometric
methods.

Normal indicators of alpha amylase in adult women and men
do not differ and on average make 20-100 IU / l, in urine – 10-124
A piece of chalk. However, standards may vary in different laboratories.

In children, the production of this enzyme is much lower. Alpha amylase
newborns are produced in small quantities, according to
as growth and development of the digestive system increases its synthesis.

Альфа амилаза, норма содержания в крови по
age
 

Age Total alpha amylase Pancreatic amylase
Newborns Up to 8 U / l 1-3 U / l
Children under 1 year 5-65 U / l 1-23 U / l
1 year – 70 years 25-125 U / l 8-51 U / l
Over 70 years old 20-160 U / l 8-65 U / l

See Symptoms of Pancreatitis, Liver Samples, Biochemical Analysis
крови, УЗИ поджелудочной, Диета при панкреатите, Заболевания
pancreas and their symptoms

When an α-amylase assay is prescribed

  • For any obscure abdominal pain, this analysis is assigned, in
    the first to diagnose acute pancreatitis (in 75% of cases
    this disease is found repeatedly increased
    enzyme in both blood and urine).
  • To diagnose chronic pancreatitis study this
    enzyme is less important: in this case alpha amylase
    raised much less often. More than half of patients have its level
    remains normal, but if you investigate fractions, then the excess
    P-type amylase activity over S-type will be of great benefit to
    диагностики хронического pancreatitis.
  • To clarify the diagnosis of mumps – inflammation of the salivary glands. AT
    In this case, the S-fraction of the enzyme will be increased in the blood.
  • To monitor the treatment of pancreatic cancer.
  • After operations in the pancreatoduodenal zone.

Causes of increased alpha amylase in the blood and urine

If pancreatic or salivary cell damage occurs
glands, their contents in large quantities begins to be absorbed into
blood, as well as vigorously excreted in the urine. Part is recycled in
the liver. In diseases of the organs of excretion (liver, kidney) its level
also rises.

The main causes of hyperamylasemia

Pancreatic diseases

  • Acute pancreatitis. Increased alpha-amylase is determined by
    the beginning of the attack, reaches a maximum after 4-6 hours and
    gradually decreases after 3-4 days. The level may
    exceed the norm by 8-10 times.
  • Обострение хронического pancreatitis. With this activity alpha
    amylase increases by 2-3 times. (see Medications for chronic
    pancreatitis).
  • Tumors, stones, pseudocysts in the pancreas.

Related to diseases of neighboring organs

  • Abdominal trauma.
  • Condition after abdominal surgery and
    retroperitoneal space.
  • Attack of hepatic colic. With the passage of the stone through the common
    bile duct enzyme level increases by 3-4 times, then
    returns to normal after 48-72 hours.

Diseases accompanied by damage to the salivary glands

  • Epidemic parotitis (mumps).
  • Bacterial Mumps
  • Stomatitis.
  • Neuralgia of the facial nerve.
  • The narrowing of the duct of the salivary gland after radiation therapy in the area
    head and neck.

Conditions in which amylase utilization decreases

  • Renal failure – disrupted amylase
    kidneys, from this it increases in the blood.
  • Fibrosis or cirrhosis of the liver in violation of its function, since
    liver cells are involved in the metabolism of this enzyme.
  • Bowel disease: inflammatory, intestinal
    obstruction, peritonitis. AT результате этих состояний фермент
    intensively absorbed into the blood.

Other states

  • ATнематочная беременность.
  • Mammary cancer.
  • Pneumonia.
  • Tuberculosis.
  • Lung cancer
  • Ovarian cancer.
  • Pheochromocytoma.
  • Blood disorders (myeloma).
  • Ketoacidosis in diabetes.
  • Macroamylasemia is a rare congenital condition when amylase
    forms compounds with large proteins and therefore cannot
    filtered by the kidneys.
  • Alcohol intoxication.
  • Acceptance of some drugs – glucocorticoids,
    opiates, tetracycline, furosemide.

Lower alpha amylase levels

ATыявление снижения этого фермента в крови имеет меньшую
diagnostic value than boost. Usually such a situation
evidence of massive necrosis of secret-producing cells
pancreas in acute inflammation, or a decrease in their
quantity in a chronic process.

Decreased serum alpha amylase may be additional
criterion for diagnosing such conditions:

  • Pancreatonecrosis.
  • Chronic pancreatitis with pronounced enzymatic
    insufficiency (in patients long suffering from this
    disease).
  • Severe hepatitis.
  • Thyrotoxicosis.
  • Cystic fibrosis – a systemic disease with damage to the external glands
    secretion.

Reduced amylase occurs with massive burns, toxemia
pregnant, diabetes. Elevated cholesterol and
triglycerides may also underestimate amylase levels.

Practical advice

  • Α-amylase testing is not a routine research, it is
    appointed only for certain indications. It makes no sense to take
    blood for this enzyme “just in case” if you don’t have anything
    worried. If acute pancreatitis is suspected, the patient is almost always
    urgently screened laboratory, including amylase.
  • Increase amylase 5 or more times in combination with abdominal pain
    almost always indicates pancreatitis.
  • If chronic pancreatitis is suspected, donate blood for
    amylase is necessary during a painful attack. She is fast enough
    half-life, and some exacerbations of the chronic process
    quite difficult to catch, after 2-3 days the level of pancreatic
    enzyme in the blood decreases to normal. This is the case when to pass
    the blood can independently and come to the doctor already with the ready
    by analysis.
  • Increases the specificity of the diagnosis of pancreatitis
    simultaneous increase in amylase and lipase.
  • Asymptomatic, “random” detection of elevated alpha amylase in
    blood, most likely not associated with pathology of the pancreas. AT
    In this case, it is necessary to investigate the fractions of the enzyme: S and P-types.
    If the S-fraction prevails, it is necessary to look for diseases, not
    associated with the pancreas.
  • If alpha amylase in the blood is increased, and in the urine is reduced, it is
    evidence of a violation of its excretion by the kidneys.
  • Some conditions can trigger an increase in amylase:
    pregnancy, contraceptive use, corticosteroids,
    furosemide, analgesics.

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