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Serum immunoreactive trypsin and pancreatic lipase in cystic fibrosis
Insights
Serum enzyme levels, including immunoreactive trypsin (IRT) and lipase, differ significantly in children with cystic fibrosis compared to healthy children. These enzyme levels correlate with pancreatic function and show distinct age-related patterns in cystic fibrosis patients.
Area of Science:
- Biochemistry
- Pediatrics
- Genetics
Background:
- Cystic fibrosis (CF) is a genetic disorder affecting multiple organs, including the pancreas.
- Pancreatic exocrine dysfunction, characterized by maldigestion and steatorrhea, is common in CF patients.
- Serum enzyme levels like immunoreactive trypsin (IRT) and lipase are potential biomarkers for pancreatic function.
Purpose of the Study:
- To investigate age-specific serum levels of immunoreactive trypsin (IRT) and pancreatic lipase in cystic fibrosis (CF) patients.
- To compare these enzyme levels with those in healthy children.
- To correlate serum enzyme levels with pancreatic exocrine function, assessed by fecal fat excretion.
Main Methods:
- Serum samples were collected from 59 CF patients (1 month to 27 years) and 120 healthy children.
- Follow-up enzyme levels were obtained from 49 CF patients.
- Fecal fat excretion was measured in 23 CF patients to assess pancreatic exocrine function.
Main Results:
- CF patients exhibited markedly elevated serum IRT and lipase in infancy, decreasing significantly below normal ranges after age 10.
- Elevated infant enzyme levels and low levels in all age groups in CF patients correlated with steatorrhea.
- Older CF patients (11-27 years) without severe pancreatic insufficiency had normal or above-normal IRT and lipase levels.
- Healthy children showed no age-dependent IRT levels, while lipase was lower in the first 12 months compared to older children.
Conclusions:
- Serum IRT and lipase levels display a distinct age-correlated pattern in cystic fibrosis, differing from healthy children.
- These enzyme levels are indicative of pancreatic exocrine function and steatorrhea in CF patients.
- The findings highlight the utility of IRT and lipase as biomarkers for monitoring pancreatic status in cystic fibrosis across different age groups.
Abstract:
Serum immunoreactive trypsin (IRT) and pancreatic lipase have been measured in 59 patients with cystic fibrosis (age 1 month-27 years). Follow-up values were obtained from 49 patients. Their serum enzyme levels were compared to those of 120 healthy children of all age groups. Faecal fat excretion was determined in selected patients (n = 23) to elucidate the relationship between serum enzyme levels and pancreatic exocrine function. In cystic fibrosis IRT and lipase showed a very similar age-correlated pattern: in infancy levels were markedly elevated. During the following years the concentrations of both enzymes decreased rapidly and were found to be far below the normal range after the 10th year of life. Elevated enzyme levels in infancy as well as low levels in all age groups coincided with steatorrhea. Older patients (11-27 years) without severe pancreatic insufficiency however, had IRT and lipase levels in or above the normal range. In healthy children there was no age dependency of IRT levels, whereas in the first 12 months of life lipase levels were significantly lower than in later childhood.