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Pancreatic elastase 1 in feces of preterm and term infants
K Nissler1, I Von Katte, A Huebner
1Children's Hospital, Technical University of Dresden, Fetscherstr. 74, D-01307 Dresden, Germany.
Insights
Fecal pancreatic elastase 1 (E1) reference values for infants are established. Adult E1 values are applicable to infants over two weeks old, regardless of feeding type or birth status.
Area of Science:
- Pediatric Gastroenterology
- Biochemistry
- Clinical Diagnostics
Background:
- Fecal pancreatic elastase 1 (E1) is a key indicator of exocrine pancreatic function.
- Existing adult reference values for E1 are not suitable for early infancy due to immature pancreatic function.
- A lack of established reference values for infants necessitates this study.
Purpose of the Study:
- To determine reference values for fecal pancreatic elastase 1 (E1) in preterm and term infants up to 12 months of age.
- To assess the applicability of adult E1 reference values in infant populations.
Main Methods:
- Fecal E1 concentration was measured in 148 infants up to 12 months of age.
- Infants with pre-existing bowel or pancreatic conditions were excluded from the analysis.
Main Results:
- Over 96% of infants showed E1 concentrations above the adult lower limit after two weeks of life.
- Preterm infants (up to 48 hours) had E1 levels below 30 microg/g meconium, while 43% of term infants met adult values.
- E1 levels were independent of gestational age, birth weight, and nutrition type after two weeks.
Conclusions:
- The adult reference value for fecal pancreatic elastase 1 (E1) (>200 microg/g feces) can be reliably applied to infants older than two weeks.
- This finding simplifies the assessment of exocrine pancreatic function in infants.
- The established reference value is applicable across different gestational ages, birth weights, and feeding types.
Background:
Determination of fecal pancreatic elastase 1 (E1) is a reliable and noninvasive test of exocrine pancreatic function. Adult reference values of greater than 200 microg E1/g feces do not seem to be applicable to early infancy because of immature pancreatic function. Because reference values for infants do not exist, the current study was aimed to define reference values for preterm and term infants up to 12 months of age.
Methods:
The authors measured pancreatic E1 concentration in feces of 148 infants up to 12 months of age. Infants with known bowel or pancreatic disorders were excluded from the study.
Results:
The authors found that 96.8% of all children had E1 concentrations greater than an adult lower limit after 2 weeks of life, independent of gestational age. Up to 48 hours after birth, none of the preterm infants had an E1 concentration of greater than 30 microg/g meconium, whereas 43% of the term infants had normal adult values.
Conclusions:
The adult reference value for pancreatic E1 of greater than 200 microg/g feces can be applied to infants older than 2 weeks, independent of gestational age, birth weight, and the type of nutrition.