Intestinal fatty acid binding protein (I-FABP) as a sensitive and specific biomarker for necrotizing enterocolitis...

Intestinal fatty acid binding protein (I-FABP) levels have been shown to be elevated in infants with necrotizing enterocolitis (NEC). We hypothesized that plasma I-FABP is a specific biomarker for NEC that can differentiate NEC from other common diseases with similar presentations in neonates.

With IRB approval, neonates born at <34 weeks' gestation had residual plasma samples scavenged from routine blood draws. Medical records were reviewed retrospectively to identify patients diagnosed with NEC and other pathologies (sepsis, feeding intolerance, and spontaneous intestinal perforation (SIP)). Samples collected within 7 days preceding and 7 days after diagnosis were utilized for plasma I-FABP quantification by ELISA. Healthy age-matched patients were selected as controls. Data were analyzed by ANOVA with mixed effects analysis in this case-control study.

Over a ten-month period 69 patients were enrolled, of which 7 were diagnosed with NEC, 9 were diagnosed with other common pathologies, and 8 were chosen as healthy controls. Plasma I-FABP was significantly higher in the NEC cohort prior to, at diagnosis, and after diagnosis compared to those with other pathologies and healthy controls (p < 0.0001). ROC curve analysis identified an I-FABP cutoff of 5.5 ng/ml as predictive of NEC compared to other pathologies with sensitivity of 75 % and specificity of 100 % (AUC 0.95).

Plasma I-FABP has the potential to distinguish between patients with NEC and healthy patients or those with other common pathologies with similar presentations (sepsis, feeding intolerance).