Gallo Antonella, Covino Marcello, Baroni Silvia, Camilli Sara, Ibba Francesca, Andaloro Silvia, Agnitelli Maria Chiara, Rognoni Fiammetta Maria, Landi Francesco, Montalto Massimo
Department of Geriatrics, Orthopedics and Rheumatology, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, 00168 Rome, Italy.
Department of Emergency Medicine, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
J Pers Med. 2024 Feb 21;14(3):227. doi: 10.3390/jpm14030227.
Fecal calprotectin (FC) has been largely recognized as a surrogate marker of intestinal neutrophilic inflammation, very reliable in distinguishing between inflammatory bowel diseases and functional gastrointestinal (GI) disorders. Aging has been suggested to influence FC results and their diagnostic accuracy; however, no studies are specifically targeted on this focus. In a retrospective study, we evaluated the eventual age-differences of the diagnostic accuracy of FC in discriminating between organic-inflammatory GI diseases and functional GI disorders. In 573 younger and 172 older (≥65 years) subjects undergoing an FC assay, we found that the latter showed higher median FC values, 72 (25-260) µg/g vs. 47 (25-165) µg/g ( < 0.01). Younger patients were more commonly affected by IBDs, while colorectal cancer and high-risk polyps, infective colitis, and diverticular disease represented the most common findings in the older subgroup. However, the estimated optimum FC threshold in discriminating between organic-inflammatory GI diseases and functional GI disorders was quite similar between the two groups (109 μg/g for the younger subgroup and 98 μg/g for the older subgroup), maintaining a very high specificity. In conclusion, we show that FC also represents a very specific test for intestinal inflammation in older patients, at similar threshold levels to younger subjects.
粪便钙卫蛋白（FC）已被广泛认为是肠道中性粒细胞炎症的替代标志物，在区分炎症性肠病和功能性胃肠（GI）疾病方面非常可靠。有研究表明衰老会影响FC结果及其诊断准确性；然而，尚无专门针对此重点的研究。在一项回顾性研究中，我们评估了FC在区分器质性炎症性胃肠疾病和功能性胃肠疾病时诊断准确性的年龄差异。在573名年轻受试者和172名老年（≥65岁）受试者中进行了FC检测，我们发现老年受试者的FC中位数较高，分别为72（25 - 260）μg/g和47（25 - 165）μg/g（P < 0.01）。年轻患者更常患炎症性肠病，而老年亚组中最常见的疾病是结直肠癌、高危息肉、感染性结肠炎和憩室病。然而，两组在区分器质性炎症性胃肠疾病和功能性胃肠疾病时，估计的最佳FC阈值相当相似（年轻亚组为109μg/g，老年亚组为98μg/g），特异性均很高。总之，我们表明FC对老年患者的肠道炎症也是一种非常特异的检测方法，其阈值水平与年轻受试者相似。
