[Serum citrulline: a potential marker for intestinal epithelial mass and absorption capacity in short bowel syndrome patients].
OBJECTIVE
To investigate the potential role of serum citrulline level in evaluating the intestinal absorptive area and capacity in patients with short bowel syndrome (SBS).


METHODS
Serum citrulline concentration was determined using high performance liquid chromatography (HPLC) in SBS patients (n=22) and healthy controls (n=33). In SBS patients, the remnant small bowel lengths and diameters were measured by radiography, and their 5- hour urine D- xylose excretion and intestinal protein absorption were also determined. The correlationship of serum citrulline level with remnant small bowel length, surface area, protein and D- xylose absorption was analyzed. The 6 patients receiving intestinal rehabilitative therapy, serum citrulline level, protein and D- xylose absorption after therapy were also measured.


RESULTS
Serum citrulline level of SBS patients was significantly lower than that of healthy controls [(5.94+/- 2.65) vs [(16.87 +/- 5.97) micromol/L, P < 0.01]. In SBS patients, serum citrulline was positively correlated with remnant small bowel length and surface area (r=0.82 and r=0.86 respectively). There was also a significant correlationship of serum citrulline level with 5- hour D- xylose excretion (r=0.56) and intestinal protein absorption (r=0.48). Serum citrulline, 5- hour D- xylose excretion and intestinal protein absorption were all significantly raised in patients after rehabilitative therapy, although no correlation of increasing percentage was found among above three parameters.


CONCLUSIONS
Serum citrulline concentration is positively correlated with intestinal absorptive area and capacity in SBS patients. It is a potential marker for evaluating the severity of intestinal failure and the efficacy of rehabilitative therapy in short bowel patients.
Research Institute of General Surgery, Nanjing Jinling Hospital, Nanjing 210002, China.
Jian-feng
JF
Gong
Wei-ming
WM
Zhu
Ning
N
Li
Fang-nan
FN
Liu
Li
L
Tan
Nan
N
Luo
Jie-shou
JS
Li
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002956:Citrulline / Q000097:blood*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012778:Short Bowel Syndrome / Q000097:blood / Q000378:metabolism* / Q000503:physiopathology*; D014994:Xylose / Q000378:metabolism; D055815:Young Adult
D002956:Citrulline; D014994:Xylose