Fundora Jennifer B, Shores Darla R, Everett Allen D, Yanek Lisa R, Northington Frances J, Gilmore Maureen M
Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Pediatr Res. 2024 Nov 16. doi: 10.1038/s41390-024-03737-9.
Intestinal fatty acid binding protein (I-FABP) is an intestinal epithelial protein detectable in infants with necrotizing enterocolitis (NEC). The longitudinal behavior of I-FABP following NEC or its association with gastrointestinal or neurodevelopmental outcomes is unknown.
In this secondary analysis of the Preterm Erythropoietin Neuroprotection Trial, we compared infants with and without NEC. Urine I-FABP concentrations in matched infants (n = 70) were measured serially using ELISA and compared using paired analysis. In infants with NEC, the associations of I-FABP levels with short-term outcomes and neurodevelopmental outcomes at 22-26 months corrected age were determined using non-parametric analysis.
Infants with NEC were more likely to have cholestasis, death or severe neurodevelopmental impairment, cerebral palsy, and lower Bayley-III motor scores. Baseline urinary I-FABP levels were similar between groups. When compared to controls, infants with NEC had urinary I-FABP concentrations that were higher at diagnosis (median 11 vs 2.6 ng/ml, p = 0.006) and lower post-NEC (median 1 vs 5 ng/ml, p = 0.002). Diagnosis I-FABP levels were not associated with gastrointestinal or neurodevelopmental outcomes at 22-26 months corrected age.
In extremely preterm infants, urinary I-FABP was elevated at NEC diagnosis and lower post-NEC compared to matched controls. I-FABP levels were not associated with adverse gastrointestinal or neurodevelopmental outcomes.
Urinary intestinal fatty acid binding protein (I-FABP) levels are increased at diagnosis of NEC and fall to below baseline after NEC in extremely preterm infants. Urine I-FABP levels at NEC diagnosis are not associated with cholestasis, intestinal stricture or obstruction, need for additional intestinal surgery after NEC, or neurodevelopmental outcomes at 22-26 months corrected age. Urine I-FABP levels may be useful in the diagnosis of NEC. Diagnostic I-FABP levels do not predict short-term gastrointestinal or neurodevelopmental outcomes after NEC.
肠脂肪酸结合蛋白（I-FABP）是一种可在坏死性小肠结肠炎（NEC）婴儿中检测到的肠上皮蛋白。NEC后I-FABP的纵向变化情况或其与胃肠道或神经发育结局的关联尚不清楚。
在这项对早产促红细胞生成素神经保护试验的二次分析中，我们比较了患有和未患有NEC的婴儿。使用酶联免疫吸附测定法（ELISA）连续测量配对婴儿（n = 70）的尿I-FABP浓度，并采用配对分析进行比较。在患有NEC的婴儿中，使用非参数分析确定I-FABP水平与22至26个月矫正年龄时的短期结局和神经发育结局之间的关联。
患有NEC的婴儿更有可能出现胆汁淤积、死亡或严重神经发育障碍、脑瘫以及较低的贝利婴幼儿发展量表第三版（Bayley-III）运动评分。两组之间的基线尿I-FABP水平相似。与对照组相比，患有NEC的婴儿在诊断时尿I-FABP浓度较高（中位数11 vs 2.6 ng/ml，p = 0.006），而在NEC后较低（中位数1 vs 5 ng/ml，p = 0.002）。诊断时的I-FABP水平与22至26个月矫正年龄时的胃肠道或神经发育结局无关。
在极早产儿中，与配对对照组相比，尿I-FABP在NEC诊断时升高，在NEC后降低。I-FABP水平与不良胃肠道或神经发育结局无关。
极早产儿在NEC诊断时尿肠脂肪酸结合蛋白（I-FABP）水平升高，在NEC后降至基线以下。NEC诊断时的尿I-FABP水平与胆汁淤积、肠道狭窄或梗阻、NEC后额外肠道手术需求或22至26个月矫正年龄时的神经发育结局无关。尿I-FABP水平可能对NEC的诊断有用。诊断时的I-FABP水平不能预测NEC后的短期胃肠道或神经发育结局。
