Serum intestinal fatty acid binding protein level for early diagnosis and prediction of severity of necrotizing enterocolitis

Background/Aim: Intestinal fatty acid binding protein (I-FABP) is found within cells at the tip of the intestinal villi, an area commonly injured in necrotizing enterocolitis (NEC). In this study, we aimed to investigate the value of serum I-FABP in early diagnosis and predicting severity of NEC. Methods: This prospective study was conducted between April 2009 and November 2009. The preterm infants with suspected NEC were included in the study. These infants were divided into two groups according to their final diagnoses; Group 1: Stage 1 NEC and Group 2: Stages 2-3 NEC (Group 2a: Stage 2 NEC, Group 2b: Stage 3 NEC). Healthy preterms were assigned to control group (Group 3). Serial blood samples were obtained from the patients at symptom onset, 24 h and 72 h later. One blood sample was taken from the controls. Serum IFABP levels were compared among the groups. Results: Initial serum I-FABP concentrations were 324.0 +/- 165.8 pg/ml, 764.7 +/- 465.1 pg/ml, and 360.2 +/- 439.5 pg/ml in Group 1, Group 2a, and Group 2b, respectively, and all were significantly higher than those of the control group (76.9 +/- 115.9 pg/ml) (p<0.001). The serum I-FABP levels gradually decreased from the onset of the disease to 72nd hour in Group 1 and Group 2a (p = 0.001). In Group 2b I-FABP concentrations slightly decreased at 24th hour of the disease and increased thereafter, but the difference was not significant (p = 0.06). Conclusion: Serial measurements of I-FABP levels may be a useful marker for early diagnosis and prediction of disease severity in NEC. (C) 2011 Elsevier Ireland Ltd. All rights reserved.