title: 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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Pediatric Surgery, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Maarten
authors.initials: M
authors.lastname: Schurink
authors.forename: Iemcke G H
authors.initials: IG
authors.lastname: Scholten
authors.forename: Elisabeth M W
authors.initials: EM
authors.lastname: Kooi
authors.forename: Christian V
authors.initials: CV
authors.lastname: Hulzebos
authors.forename: Rozemarijn G
authors.initials: RG
authors.lastname: Kox
authors.forename: Henk
authors.initials: H
authors.lastname: Groen
authors.forename: Erik
authors.initials: E
authors.lastname: Heineman
authors.forename: Arend F
authors.initials: AF
authors.lastname: Bos
authors.forename: Jan B F
authors.initials: JB
authors.lastname: Hulscher
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000652:urine; D002097:C-Reactive Protein / Q000378:metabolism; D003404:Creatinine / Q000652:urine; D020345:Enterocolitis, Necrotizing / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000652:urine; D050556:Fatty Acid-Binding Proteins / Q000097:blood* / Q000652:urine; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000652:urine; D015850:Interleukin-6 / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D010976:Platelet Count; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D015415:Biomarkers; C493404:FABP2 protein, human; D050556:Fatty Acid-Binding Proteins; D015850:Interleukin-6; D019344:Lactic Acid; D002097:C-Reactive Protein; D003404:Creatinine