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Fecal elastase-1 in healthy children up to 2 years of age: a cross-sectional study
Mirosława Wieczorek-Filipiak1, Sławomira Drzymała-Czyż1, Mariusz Szczepanik1
1Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznań, Poland.
Insights
Fecal elastase-1 (E-1) levels are reliable for assessing pancreatic function in infants. However, E-1 concentrations are lower in the first few months of life compared to later in infancy.
Area of Science:
- Pediatric Gastroenterology
- Pancreatic Function Testing
- Infant Nutrition
Background:
- Fecal elastase-1 (E-1) levels may vary in infants due to gastrointestinal immaturity and diet.
- Limited data exists on E-1 levels in healthy infants and toddlers.
- Previous studies focused on preterm infants, older children, adults, and those with malabsorption.
Purpose of the Study:
- To evaluate fecal E-1 concentrations in healthy infants and children aged 1-24 months.
- To establish reference values for fecal E-1 in this age group.
- To determine the reliability of the fecal E-1 test in young children.
Main Methods:
- A cross-sectional study involving 160 healthy infants and children aged 1-24 months.
- Subjects were divided into 8 age groups (20 per group).
- Fecal E-1 was measured using enzyme-linked immunosorbent assay (ELISA).
Main Results:
- Fecal E-1 concentrations ranged from 200 to 1695 μg/g, with no levels below 200 μg/g.
- E-1 levels showed a statistically significant increase with age (p=0.0007), reaching a plateau around 6-10 months.
- While not significantly different between all groups, levels in the first 3 months were lower than in the second year (p=0.0230).
Conclusions:
- The fecal E-1 test is a reliable tool for confirming normal exocrine pancreatic function in infants and toddlers.
- Fecal E-1 concentrations can be lower during the initial months of life.
- Established reference ranges support the use of fecal E-1 testing in pediatric populations.
Background:
Fecal elastase-1 (E-1) levels in infants and young children may be expected to differ from those in adults and older children because of the immaturity of the gastrointestinal tract and the specificity of their diet. Despite the availability of data describing E-1 levels in the stools of preterm infants, older children, adults and subjects with malabsorption, there is still a lack of data regarding E-1 in healthy infants and toddlers. The aim of this cross-sectional study was to evaluate fecal E-1 concentrations in infants and children from 1 up to 24 months of age.
Material And Methods:
E-1 was measured in 160 healthy subjects aged 1-24 months (8 groups of 20: aged 1-3, 4-6 months, etc.) using an enzyme-linked immunosorbent assay (ELISA).
Results:
Fecal E-1 concentrations ranged from 200 to 1695 μg/g of feces. No child had a fecal E-1 level below 200 μg/g of feces. Fecal E-1 concentrations did not significantly differ between age groups. However, fecal E-1 levels in the first 3 months were lower than in the second year of life (1-3 months vs 13-24 months, p=0.0230). A statistically significant correlation between the E-1 concentration and age was found (p=0.0007, r=0.2639; however, it does not affect the cut-off level of the reference values). The trend was rather exponential. Fecal E-1 values reached a plateau around the age of 6-10 months.
Conclusions:
Our study has shown that the fecal E-1 test can be reliably applied in infants and toddlers to confirm normal exocrine pancreatic function. However, within the first months of life fecal E-1 concentrations may be lower than later in life.
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