APHP, Department of Gastroenterology, IBD and Intestinal Failure, Intestinal Stroke Center, Structure d'Urgences Vasculaires Intestinales (SURVI), Hôpital Beaujon, 100 Bd du Général Leclerc, 92110, Clichy, France.
Laboratory for Vascular Translational Science, INSERM UMR 1148, Université de Paris, 75018, Paris, France.
Sci Rep. 2021 Sep 23;11(1):18929. doi: 10.1038/s41598-021-98012-w.
Early diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI-citrulline, intestinal fatty acid-binding protein (I-FABP), and D-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients-50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 μmol/L (12.0-26.0) vs. 23.3 μmol/L (18.3-29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58-0.78). No statistical difference was found in plasma I-FABP and plasma D-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and D-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.
早期诊断急性肠系膜缺血（AMI）仍然是临床面临的挑战，目前尚无经过一致验证的生物标志物。我们旨在评估三种有前景的循环生物标志物（瓜氨酸、肠脂肪酸结合蛋白（I-FABP）和 D-乳酸）用于诊断 AMI 的准确性。一项横断面诊断研究纳入了因 AMI 入住肠卒中中心的患者和因其他原因出现急性腹痛的对照组。共纳入 129 名患者，50 名 AMI 患者和 79 名对照组。与对照组相比，AMI 患者的血浆瓜氨酸浓度明显更低[15.3 μmol/L（12.0-26.0）vs. 23.3 μmol/L（18.3-29.8），p=0.001]。然而，瓜氨酸诊断 AMI 的受试者工作特征曲线下面积（AUROC）较低：0.68（95%置信区间=0.58-0.78）。AMI 组和对照组之间的血浆 I-FABP 和血浆 D-乳酸浓度无统计学差异，AUROC 分别为 0.44 和 0.40。在这项大型横断面研究中，瓜氨酸、I-FABP 和 D-乳酸均未能区分 AMI 患者与其他原因导致的急性腹痛患者。进一步的研究应集中于新生物标志物的发现。
