Intestinal Fatty Acid-Binding Protein in Neonates with Imminent Necrotizing Enterocolitis

Abstract

Background: Intestinal fatty acid-binding protein (I-FABP) is a promising marker for necrotizing enterocolitis (NEC). It can be measured in plasma (I-FABPp) and urine (I-FABPu). Data on the best way to measure I-FABP (in plasma or urine) and the necessity of simultaneous measurement of the urinary creatinine concentration to correct for physiological variations in urine concentration are not available. This holds also true for the reciprocal relation between I-FABPp, I-FABPu and other more conventional laboratory parameters. Objectives: To evaluate the above-mentioned correlations of I-FABP measurements in neonates with suspected NEC. Methods: All neonates with suspected NEC were prospectively included. I-FABPp and I-FABPu were analyzed at regular intervals during the first 24 h after onset of symptoms. Correlation and agreement were assessed between these and other parameters (i.e. IL-6, WBC, platelet count, CRP, pH and lactate). Results: Included were 24 boys, 13 girls [median (range) GA 28 weeks (24-36), median birth weight 1,190 g (570-2,400)]. I-FABPu correlated strongly with I-FABPp (r 0.80, p < 0.001) with an adequate agreement. A very strong correlation between I-FABPu and I-FABPu/urine creatinine ratio (r 0.98, p < 0.001) existed. Correlations between I-FABPp/u and conventional parameters were moderate to strong until 8 h after onset of symptoms. Conclusion: In neonates with suspected NEC, I-FABPu correlates strongly with I-FABPp, offering an opportunity to choose the most appropriate way of measuring I-FABP. Calculating urinary IFABP/creatinine ratio seems redundant. Moderately strong correlations between I-FABPu and IL-6, WBC and lactate were found.

Impact of clinical context on acute kidney injury biomarker performances: differences between neutrophil gelatinase-associated lipocalin and L-type fatty acid-binding protein

“…Conversely, L-FABP was shown to reflect organ hypoperfusion, including that in the kidney and liver4344. In neonates with necrotising enterocolitis, urinary L-FABP levels were shown to correlate with blood lactate levels45. The results of our principal component analysis were supported by these studies: Urinary NGAL correlated with markers of inflammation, whereas L-FABP showed significant linear correlations with hypoperfusion and hepatic injury markers (Fig.…”

The role of serum intestinal fatty acid binding protein levels and D-lactate levels in the diagnosis of acute intestinal ischemia

“…Some investigators have reported elevation of serum I-FABP levels in patients with occlusion of the superior mesenteric artery [6], strangulated obstruction of the bowel [7], celiac disease [8], necrotizing enterocolitis [9], and ulcerative colitis [10]. These findings suggest that I-FABP values can provide information regarding the extent of intestinal epithelial cell damage.…”

Gut epithelial barrier markers in patients with obstructive sleep apnea

“…The cyclical changes of hypoxemia with reoxygenation could represent an important mechanism for the presence of intestinal damage in OSA, independent of metabolic disturbances. Disruption of the gut wall integrity and leakage of macromolecules and microbial products from the intestinal lumen into the circulation can induce local and systemic inflammatory responses [19][20][21]. The present results suggest that OSA might contribute to gut mucosal injury, which might have important clinical implications.…”