Citrullinemia stimulation test in the evaluation of the intestinal function

Area of Science:

• Gastroenterology and Hepatology
• Clinical Biochemistry
• Surgical Gastroenterology

Background:

• Citrullinemia serves as a quantitative marker for enterocyte mass and function.
• Evaluating intestinal function is crucial for managing gastrointestinal disorders.

Purpose of the Study:

• To analyze the diagnostic value of fasting and stimulated citrullinemia levels in assessing intestinal function.
• To determine the utility of the citrullinemia stimulation test in patients with short bowel syndrome and post-bariatric surgery.

Main Methods:

• A case-control study involving 11 short bowel syndrome patients, 13 bariatric surgery patients, and 11 healthy controls.
• Plasma amino acid levels were measured using ion-exchange chromatography before and after oral L-glutamine stimulation.
• Analysis included baseline citrullinemia and the change in citrullinemia (ΔCitrullinemia80) at 80 minutes.

Main Results:

• Citrullinemia levels were lower in short bowel syndrome patients compared to controls and bariatric surgery patients.
• A baseline citrullinemia level below 25.5 μmol/L was observed in 54.5% of short bowel syndrome patients, with significant accuracy (74%) and odds ratio (3).
• ΔCitrullinemia80 showed high predictive capacity for short bowel length ≤ 50 cm (area under ROC curve = 82.3%).

Conclusions:

• The citrullinemia stimulation test with L-glutamine is feasible in the context of short bowel syndrome.
• This test has the potential to enhance the predictive capacity for short bowel syndrome severity.
• Further research is needed to establish the clinical relevance and broader applicability of this diagnostic approach.