Serum Lipase Amylase Ratio as an Indicator to Differentiate Alcoholic From Non-alcoholic Acute Pancreatitis: A Systematic Review and Meta-Analysis

Abstract

A lipase/amylase (L/A) ratio of more than three may be a tool for differentiating alcoholic pancreatitis from non-alcoholic pancreatitis. We conducted a systematic literature review to identify published studies. A thorough data search of various databases was conducted using keywords. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 survey. Data were extracted under the following headings: country, sample size, baseline characteristics, specificity, and sensitivity of the L/A ratio. Studies were analyzed using a bivariate random-effects model, and the sensitivity and specificity of the L/A ratio were pooled separately. Summary receiver operating characteristic (SROC) curves were plotted using the hierarchical method. A total of nine studies with 1,825 patients were identified for inclusion. SROC showed estimates of the area under the curve to be 0.75 (confidence interval (CI) = 0.71-0.79). Forest plots for sensitivity and specificity showed pooled estimates of sensitivity to be 74% (95% CI = 62-83%) while that of specificity was 63% (95% CI = 47-77%). The pooled diagnostic odds ratio was estimated to be 5 (95% CI = 3-9), the pooled positive likelihood ratio was estimated at 2.0, and the pooled negative likelihood ratio was estimated to be 0.41. We concluded that an L/A ratio of more than 3 has moderate accuracy for the diagnosis of alcoholic pancreatitis.

Forecasting Severities and Etiology of Acute Pancreatitis by Using Pancreatic Enzymes and Lipase: Amylase Ratio

“…This findings were also supported by Ekka et al, (2023), who had concluded that Lipase: Amylase ratio >3 had moderate accuracy for predicting alcoholic etiology of pancreatitis and could be used to predict alcoholism in the absence of better diagnostic methods. Prospective study by Singh et al, (2020) documented that lipase: Amylase ratio in acute alcoholic pancreatitis was ≥3, while in acute biliary pancreatitis ratio was <3 and this distinction were statistically significant (p<0.05).…”

β-Carotene Supplementation Improves Pancreas Function during Moderate Ethanol Consumption: Initial Characterization from a Morphological Overview

“…Hence, an increase in serum total amylase levels is not exclusive to pancreatitis, and it is important to evaluate other illnesses as well [40]. The L/A ratio is an acceptable indicator of alcohol-induced pancreatitis [41]. In fact, L/A ratio can be used to distinguish between pancreatitis caused by alcohol use and pancreatitis not caused by alcohol [42].…”