title: Fecal Bile Salts and the Development of Necrotizing Enterocolitis in Preterm Infants.
abstract: BACKGROUND
  Intestinal bile salts (BSs) may be implicated in NEC development. We hypothesized that fecal BS levels are higher in preterm infants at risk for NEC.
  
  
  METHODS
  We compared the composition and concentration of fecal BSs in ten preterm infants who developed NEC (Bell's Stage ≥ II) with twenty matched control infants without NEC. Conjugated and unconjugated fecal BSs were measured after birth (T1) and twice prior to NEC (T2, T3). Data are presented as medians and interquartile ranges.
  
  
  RESULTS
  GA and BW were similar in all preterms: ~27+4 weeks and ~1010 g. Age of NEC onset was day 10 (8-24). T1 was collected 2 (1-3) days after birth. T2 and T3 were collected 5 (5-6) days and 1 (0-2) day before NEC or at corresponding postnatal ages in controls. The composition of conjugated BSs did not differ between the two groups. Total unconjugated BSs were 3-fold higher before NEC compared to controls at corresponding ages (0.41 μmol/g feces (0.21-0.74) versus 0.14 μmol/g feces (0.06-0.46), p < 0.05).
  
  
  CONCLUSIONS
  Fecal BS concentrations are higher in preterm infants who develop NEC compared to infants without NEC. Further study is needed to determine the predictive value of fecal BSs in the development of NEC.
authors.affiliation: Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Christian V
authors.initials: CV
authors.lastname: Hulzebos
authors.affiliation: Department of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Anne G J F
authors.initials: AG
authors.lastname: van Zoonen
authors.affiliation: Department of Pediatric Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Jan B F
authors.initials: JB
authors.lastname: Hulscher
authors.affiliation: Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Trijntje E
authors.initials: TE
authors.lastname: Schat
authors.affiliation: Department of Pediatrics, Division of Neonatology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Elisabeth M W
authors.initials: EM
authors.lastname: Kooi
authors.affiliation: Department of Pediatrics, Division of Hepatology/Gastroenterology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Koehorst
authors.affiliation: Department of Pediatrics, Division of Hepatology/Gastroenterology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Renze
authors.initials: R
authors.lastname: Boverhof
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Paul F M
authors.initials: PF
authors.lastname: Krabbe
authors.affiliation: Department of Pediatrics, Division of Hepatology/Gastroenterology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.|Amsterdam Diabetes Center, Department of Vascular Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Albert K
authors.initials: AK
authors.lastname: Groen
authors.affiliation: Department of Pediatrics, Division of Hepatology/Gastroenterology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Henkjan J
authors.initials: HJ
authors.lastname: Verkade
mesh_terms: D001647:Bile Acids and Salts / Q000737:chemistry*; D016022:Case-Control Studies; D020345:Enterocolitis, Necrotizing / Q000503:physiopathology*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D016896:Treatment Outcome
chemical_list: D001647:Bile Acids and Salts