Department of Gastroenterology & Metabolism, 1st Chair of Pediatrics, Poznan University of Medical Sciences, Szpitalna 27/33, 60-572 Poznań , Poland.
Pediatr Pulmonol. 2010 Mar;45(3):249-54. doi: 10.1002/ppul.21149.
Most methods used for the assessment of severe steatorrhea in cystic fibrosis (CF) are sensitive. In fact, the tests show their usefulness in a borderline zone of the results. Yet, the existing data related to acid steatocrit (AS) are still contradictory. Therefore, in the present study we have aimed to assess CF patients without or with mild steatorhea (<10 g/day) and evaluate the applicability of AS in such a subset of patients.
In fifty-five CF patients, AS, fecal fat concentration (FFC) and fecal fat excretion (FFE) in 1-day stool collection were assessed from one to three times (149 samples). In 50 subjects, FFC, FFE, and AS were available for 3 subsequent days. It allowed for the calculations based upon 3-day fecal fat balance study.
The correlations between FFE/FFC and AS based upon 1-day stool collection, although statistically significant, were rather weak (r = 0.208, P < 0.011; r = 0.362, P < 0.000006, respectively). The correlations between FFE/FFC and AS based upon the 3-day stool collection, although stronger, did not show values a linear relationship (r = 0.394, P < 0.005; r = 0.454, P < 0.001, respectively). With no regard to the cut-off level for AS (10% and 20%), sensitivity, specificity, negative, and positive predictive values in the determination of abnormal FFC and FFE were not satisfactory. The flow charts describing the accuracy of AS to determine FFE and FC revealed a high level of uncertainty.
AS does not reflect in a reliable way FFE in CF patients without or mild steatorrhea. Its applicability in the assessment of FFC in such patients has therefore limited practical value.
大多数用于评估囊性纤维化（CF）严重脂肪泻的方法都很敏感。事实上，这些测试在结果的边界区域显示出其有用性。然而，与酸脂肪比（AS）相关的现有数据仍然存在矛盾。因此，在本研究中，我们旨在评估无或轻度脂肪泻（<10 g/天）的 CF 患者，并评估 AS 在该亚组患者中的适用性。
在 55 名 CF 患者中，在 1 天粪便收集时评估了 AS、粪便脂肪浓度（FFC）和粪便脂肪排泄（FFE），评估次数为 1 到 3 次（共 149 个样本）。在 50 名患者中，FFC、FFE 和 AS 可用于 3 天。这允许基于 3 天粪便脂肪平衡研究进行计算。
基于 1 天粪便收集的 FFE/FFC 与 AS 之间的相关性虽然具有统计学意义，但相关性较弱（r = 0.208，P <0.011；r = 0.362，P <0.000006，分别）。基于 3 天粪便收集的 FFE/FFC 与 AS 之间的相关性虽然更强，但没有显示出线性关系的值（r = 0.394，P <0.005；r = 0.454，P <0.001，分别）。无论 AS 的截断值（10%和 20%）如何，确定异常 FFC 和 FFE 的敏感性、特异性、阴性和阳性预测值均不理想。描述 AS 确定 FFE 和 FC 准确性的流程图显示出高度的不确定性。
AS 不能可靠地反映 CF 患者无或轻度脂肪泻时的 FFE。因此，其在评估此类患者的 FFC 中的适用性具有有限的实际价值。
