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Longitudinal analysis of urinary I-FABP in extremely preterm infants that develop necrotizing enterocolitis.
Jennifer B Fundora1, Darla R Shores2, Allen D Everett2
1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA. jfundor1@jhmi.edu.
Pediatric Research
|November 16, 2024
Summary
Urinary intestinal fatty acid binding protein (I-FABP) is elevated at necrotizing enterocolitis (NEC) diagnosis in preterm infants but falls post-NEC. However, I-FABP levels do not predict NEC-related gastrointestinal or neurodevelopmental outcomes.
Area of Science:
- Neonatal research
- Gastroenterology
- Biomarker discovery
Background:
- Intestinal fatty acid binding protein (I-FABP) is an intestinal epithelial protein.
- I-FABP is detectable in infants with necrotizing enterocolitis (NEC).
- The longitudinal behavior and predictive value of I-FABP in NEC are unknown.
Purpose of the Study:
- To compare urinary I-FABP levels in infants with and without NEC.
- To investigate the association of I-FABP levels with short-term and neurodevelopmental outcomes in NEC infants.
Main Methods:
- Secondary analysis of the Preterm Erythropoietin Neuroprotection Trial.
- Serial urine I-FABP measurements using ELISA in matched infants (n=70).
- Non-parametric analysis to determine associations with outcomes.
Main Results:
- Infants with NEC showed higher I-FABP at diagnosis (11 vs 2.6 ng/ml) and lower levels post-NEC (1 vs 5 ng/ml) compared to controls.
- NEC diagnosis was associated with cholestasis, death, severe neurodevelopmental impairment, cerebral palsy, and lower motor scores.
- Diagnosis I-FABP levels were not associated with gastrointestinal or neurodevelopmental outcomes.
Conclusions:
- Urinary I-FABP is elevated at NEC diagnosis and decreases post-NEC in extremely preterm infants.
- I-FABP levels at NEC diagnosis do not predict adverse gastrointestinal or neurodevelopmental outcomes.
- Urinary I-FABP may aid in NEC diagnosis but not in predicting outcomes.
