Serum Lipase and Serum Amylase Levels in Non-Pancreatic Abdominal Pain versus Acute Pancreatitis in A Hospital in Eastern UP

Abstract Background: Acute pancreatitis is a life-threatening condition, quite often associated with gastrointestinal distress, and many complications can arise. Early diagnosis relies heavily on biochemical markers like serum amylase or lipase often in quite obscure clinical contexts. Diagnostic accuracy between these markers remains debated, especially when distinguishing AP from other causes of severe abdominal pain. Objectives: To assess and compare the serum lipase and serum amylase diagnostic value in distinguishing acute pancreatitis from non-pancreatic acute abdominal pain. Methods: In Eastern Uttar Pradesh, a tertiary care facility conducted prospective observational research on adult patients who presented with acute abdominal discomfort. Based on clinical, biochemical, and imaging criteria, patients were categorized into AP and non-pancreatic pain groups. Serum lipase and amylase levels were assessed 12–38 hours after the beginning of symptoms. The diagnostic accuracy was assessed using the sensitivity, specificity, and receiver operating characteristic (ROC) curves. Results: The mean age was 41.30 ± 14.96 years in the AP group and 44.87 ± 17.52 years in the non-pancreatic group (p = 0.144). Vomiting (24.39% vs 13.59%, p = 0.049) and constipation (18.29% vs 0%, p < 0.001) were significantly more common in the AP group. Mean serum amylase and lipase levels were significantly elevated in AP patients (amylase: 300.92 ± 265.70 U/L vs 84.45 ± 113.36 U/L; lipase: 177.44 ± 145.68 U/L vs 57.79 ± 36.09 U/L; both p < 0.001). ROC analysis showed serum amylase had an AUC of 0.847 (cut-off: 81 U/L, sensitivity 84.1%, specificity 65.5%) and serum lipase had an AUC of 0.823 (cut-off: 56 U/L, sensitivity 80.5%, specificity 62.1%). Conclusion: Both serum amylase and lipase are valuable diagnostic markers in acute pancreatitis, with amylase showing slightly better diagnostic performance in this cohort. Serum lipase remains a reliable and non-invasive tool, particularly when used in conjunction with clinical and imaging findings.