Which of the following laboratory or clinical findings would most likely indicate reduced pancreatic lipase activity?

• A. Increased urinary ketone excretion overnight after a lipid-rich meal, reflecting the overproduction of ketone bodies directly within the small intestinal lumen as a result of pancreatic enzyme excess.
• B. Marked increase in serum glucose immediately after a fatty meal due to compensatory gluconeogenesis from unhydrolyzed triglycerides in the intestinal lumen being absorbed intact by hepatocytes.
• C. An isolated elevation in plasma albumin concentration, because unabsorbed triglycerides promote hepatic albumin synthesis to bind free fatty acids remaining in circulation.
• D. Elevated fat content in stool (steatorrhea) with reduced postprandial rise in plasma chylomicron triglycerides, because inadequate hydrolysis of triglycerides limits the formation of absorbable monoglycerides and free fatty acids and thus reduces chylomicron assembly.

Answer: (D)