Biochemistry Test


Dr. Nithin Jayan
Medically Reviewed by Dr. Nithin Jayan, MBBS, DNB
Last Updated on Mar 28, 2014
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Test : Amylase

Indications :

Amylase tests requested in the following cases, ()

  • To diagnose and monitor acute and chronic pancreatitis or other conditions of the pancreas
  • To monitor kidney dysfunction (test done along with urine creatinine). In case of kidney malfunction the clearance for both amylase and creatinine is slow
  • To monitor progress made in pancreatic cancer treatment
  • To monitor progress after gall stone removal
Symptoms of pancreatic diseases are, ()
  • Severe abdominal pain or back pain
  • Fever
  • Loss of appetite
  • Nausea, and vomiting
  • Rapid heart rate
  • Lowered blood pressure
  • Jaundice

In some cases, both urine and blood amylase are tested. Blood for the test is drawn intravenously from the upper forearm and fasting is required before the procedure.

For urine amylase test, a 24 hours urine sample needs to be collected. No alcohol must be consumed 24 hrs prior to the test. It is advised to avoid the first morning uring sample for the test. Consecutive urine samples must be collected in a small container and poured into a larger container. This larger container needs to be refrigerated ().

Make sure the urine sample is not contaminated with pubic hair, toilet paper, stool or any other foreign objects. Ensure adequate water intake to avoid dehydration.

Risks of drawing blood for blood test include (),
  • Excessive bleeding
  • Fainting
  • Blood accumulation under the skin
  • Infection

Physiology :

Amylase is an enzyme which is present in the human saliva. It initiates the process of digestion and plays an important role in converting dietary starch into simpler sugars.

The reason why foods that consist of complex starch, such as potato and rice taste mildly sweet when chewed, is the action of the enzyme amylase.

Amylase (alpha amylase) is also present in pancreas and this aids in hydrolyzing the starch in our diet into disaccharides and trisaccharides, which are eventually converted into glucose by other enzymes. Amylase is also produced by some forms of bacteria and plants ().

Normal Range : The normal range is 40 to 140 units per liter (U/L) or 0.38 to 1.42 microkat/L (µkat/L). ()

Interpretation :

Normal values

Amylase in Blood
Adults – 60 yrs and younger 25-125 units per liter (U/L)
Adults - older than 60 yrs 24-151 U/L
Amylase in urine
2-hour urine sample 2-34 U /day
24-hour urine sample 24-408 U /day
Amylase/creatinine clearance ratio
Normal 1%-4% or 0.01-0.04 clearance fraction
Higher than normal values indicate (),
  • Acute /chronic pancreatitis
  • Pancreatic cancer
  • Blockage in a duct in the pancreas
  • Blocked intestine
  • Lack of blood flow to the intestines
Lower than normal values indicate (),
  • Chronic pancreatitis
  • Kidney disease
  • Cystic fibrosis
  • Liver disease
  • High blood pressure in pregnancy

S-amylase and P- amylase are variants of the amylase enzyme. The former is found in the salivary glands and the latter, which is evaluated to diagnose pancreatic conditions, is found in the pancreas.

High amylase values does not necessarily mean to have a pancreatic condition. It can also be caused by gall stones. Both urine and blood amylase levels can be increased in a variety of conditions such as (),

  • Ovarian and lung cancer
  • Tubal pregnancy
  • Diabetic ketoacidosis
  • Mumps
  • Intestinal obstruction
  • Acute appendicitis
  • Perforated ulcer
  • By certain medications
However, the amylase test is not used to monitor any of these conditions.

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