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Normal fecal calprotectin levels in healthy children are higher than in adults and decrease with age
Marta Velasco Rodríguez-Belvís1, Javier Francisco Viada Bris1, Carmen Plata Fernández2
1Gastroenterology and Nutrition Department, Hospital Infantil Universitario Nino Jesus, Madrid, Spain.
Insights
Pediatric fecal calprotectin (FC) levels are higher in infants and decrease with age. This study established normal FC ranges in healthy children, finding age is the primary factor influencing levels.
Area of Science:
- Pediatric Gastroenterology
- Clinical Biochemistry
Background:
- Establishing reliable pediatric reference ranges for fecal calprotectin (FC) is crucial due to wide age-related variability.
- Factors such as anthropometrics and feeding type may influence FC levels in children.
Purpose of the Study:
- To establish normal fecal calprotectin (FC) levels in healthy children, stratified by age.
- To investigate the influence of sex, gestational age, birth weight, delivery type, feeding type, and anthropometric data on pediatric FC values.
Main Methods:
- A multicenter, cross-sectional, observational study included 395 healthy children under 18 years.
- Exclusion criteria focused on conditions and factors that could affect FC levels, such as immunodeficiency, gastrointestinal disease, and medication use.
Main Results:
- A significant negative correlation was observed between age and FC levels (Spearman's rho = -0.603, P<0.01).
- The median FC level was 77.0 mcg/g (IQR 246).
- No significant influence was found for sex, gestational age, birth weight, delivery type, feeding type, or anthropometric data on FC levels.
Conclusions:
- Normal FC values in healthy children are higher than adult levels and decrease with age.
- Current upper limits for FC in pediatric patients may need age-specific reconsideration.
- Further research is needed to understand FC variations during infancy.
Background/Objectives:
The paediatric reference range of fecal calprotectin (FC) has not been decisively established and previous studies show a wide within-age variability, suggesting that other factors like anthropometric data or type of feeding can influence FC. Our aims were to establish the normal levels of FC in healthy children grouped by age and analyze whether sex, gestational age, birth weight, type of delivery, type of feeding, or anthropometric data influence FC values.
Methods:
This multicentre, cross-sectional, and observational study enrolled healthy donors under 18 years of age who attended their Primary Health Care Centre for their routine Healthy Child Program visits. The exclusion criteria were: (i) immunodeficiency, (ii) autoimmune or (iii) gastrointestinal disease; (iv) medication usage; (v) gastrointestinal symptoms; or (vi) positive finding in the microbiological study.
Results:
We enrolled 395 subjects, mean age was 4.2 years (range 3 days to 16.9 years), and 204 were male. The median FC was 77.0 mcg/g (interquartile range 246). A negative correlation between age and FC was observed (Spearman's rho = -0.603, P<0.01), and none of the other factors analyzed were found to influence FC levels.
Conclusions:
Normal FC values in healthy children (particularly in infants) are higher than those considered to be altered in adults and show a negative correlation with age. It is necessary to reconsider the upper limits of FC levels for paediatric patients according to age, with further studies required to determine other factors that influence FC during infancy.
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