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.
Abstract

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