Intestinal fatty acid-binding protein in neonates with imminent necrotizing enterocolitis

Maarten Schurink, Iemcke G. H. Scholten, Elisabeth M. W. Kooi, Christian V. Hulzebos, Rozemarijn G. Kox, Henk Groen, Erik Heineman, Arend F. Bos, Jan B. F. Hulscher*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

28 Citations (Scopus)


BACKGROUND: Intestinal fatty acid-binding protein (I-FABP) is a promising marker for necrotizing enterocolitis (NEC). It can be measured in plasma (I-FABPp) and urine (I-FABPu). Data on the best way to measure I-FABP (in plasma or urine) and the necessity of simultaneous measurement of the urinary creatinine concentration to correct for physiological variations in urine concentration are not available. This holds also true for the reciprocal relation between I-FABPp, I-FABPu and other more conventional laboratory parameters.

OBJECTIVES: To evaluate the above-mentioned correlations of I-FABP measurements in neonates with suspected NEC.

METHODS: All neonates with suspected NEC were prospectively included. I-FABPp and I-FABPu were analyzed at regular intervals during the first 24 h after onset of symptoms. Correlation and agreement were assessed between these and other parameters (i.e., IL-6, WBC, platelet count, CRP, pH and lactate).

RESULTS: Included were 24 boys, 13 girls [median (range) GA 28 weeks (24-36), median birth weight 1,190 g (570-2,400)]. I-FABPu correlated strongly with I-FABPp (r 0.80, p < 0.001) with an adequate agreement. A very strong correlation between I-FABPu and I-FABPu/urine creatinine ratio (r 0.98, p < 0.001) existed. Correlations between I-FABPp/u and conventional parameters were moderate to strong until 8 h after onset of symptoms.

CONCLUSION: In neonates with suspected NEC, I-FABPu correlates strongly with I-FABPp, offering an opportunity to choose the most appropriate way of measuring I-FABP. Calculating urinary IFABP/creatinine ratio seems redundant. Moderately strong correlations between I-FABPu and IL-6, WBC and lactate were found.

Original languageEnglish
Pages (from-to)49-54
Number of pages6
Issue number1
Publication statusPublished - 2014


  • Imminent necrotizing enterocolitis
  • Intestinal fatty acid-binding protein
  • Necrotizing enterocolitis
  • Urinary I-FABP/creatinine ratio

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