title: Ischemia-modified albumin may be a novel marker for the diagnosis and follow-up of necrotizing enterocolitis.
abstract: OBJECTIVE
  We investigate the efficacy of serial ischemia-modified albumin (IMA) measurements in diagnosis and follow-up of necrotizing enterocolitis (NEC), and compare its effectiveness with C-reactive protein (CRP), interleukin-6 (IL-6), in NEC.
  
  
  METHODS
  Preterm infants, whose gestational age and weight matched each other, were grouped as control (n = 36) and NEC (n = 37). IMA, CRP, IL-6 levels were measured on the third day of life for the control group and on the day of diagnosis (first day), third, and seventh days of NEC.
  
  
  RESULTS
  IMA, CRP, and IL-6 levels were significantly increased in NEC patients compared to the control group (P < 0.001) on the follow-up. IMA levels were significantly higher in infants with stage-III NEC than those in infants with stage-II NEC on the first, third, and seventh days (P < 0.001). The area under curve for IMA (0.815 at diagnosis, 0.933 at the third day, 0.935 at the seventh day) were significantly higher than CRP and IL-6 at all days for predicting perforation in infants with NEC (P < 0.001). Similarly, the area under curve for IMA (0.952 at diagnosis, 0.929 at the third day, 0.971 at the seventh day) was significantly higher than CRP and IL-6 at all consequent days of diagnosis for predicting mortality in infants with NEC (P < 0.001).
  
  
  CONCLUSIONS
  Ischemia-modified albumin was found to be superior to CRP and IL-6 in both diagnosis and follow-up of NEC.
authors.affiliation: Department of Pediatrics, Ankara Pediatric & Pediatric Hematology, Oncology Training and Research Hospital, Ankara, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Yakut
authors.forename: Cüneyt
authors.initials: C
authors.lastname: Tayman
authors.forename: Osman
authors.initials: O
authors.lastname: Oztekin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Namuslu
authors.forename: Fahri
authors.initials: F
authors.lastname: Karaca
authors.forename: Aydin
authors.initials: A
authors.lastname: Kosus
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D016015:Logistic Models; D012709:Serum Albumin; D000075462:Serum Albumin, Human
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D012709:Serum Albumin; C561522:ischemia-modified albumin; D002097:C-Reactive Protein; D000075462:Serum Albumin, Human
keywords: diagnosis; ischemia-modified albumin; necrotizing enterocolitis; newborn; preterm