Intestinal Fatty Acid-Binding Protein (I-FABP) as a Diagnostic Early Marker for Necrotizing Enterocolitis in Prematuraly Born Infants

Background: I-FABP is mainly located in the enterocytes of the small intestine and released into the blood after NEC-associated inflammation.

Objective: Тo establish diagnostic level of I-FABP for the study of necrotizing enterocolitis of premature infants.

Methods: The study group - 95 premature infants with necrotizing enterocolitis (NEC) who were treated in the NICU. The first group consisted of 27 preterm infants with NEC І stage, the second group - 35 preterm infants with NEC ІІ stage, the third group - 8 preterm infants with NEC of the 3rd stage. The control group - 25 preterm infants without NEC. I-FABP measurements in the blood serum were obtained using the Human I-FABP (Hycult Biotech, Netherlands) ELISA Test System. The statistical processing was carried out using the software package Statistica 6.1.

Results: In the first group, the I-FABP content was 831,0 [582-974] pg/ml, in second group - 1037,0 [862-1846] pg/ml, in third group - 1856,5 [1627-2756] pg/ml, which significantly exceeded the value of I-FABP in the control group - 269,0 [226-346] pg/ml (p<0.01). The serum I-FABP value of ≥ 727.50 pg / ml allows to identify NEC in premature babies with a sensitivity of 73.6% and a specificity of 72.2%, obtained by ROC analysis, the area under the ROC curve (AUC) is 0.883 [95% CI 0.806-0.961], indicating a high diagnostic value of the model.

Conclusions: The content of I-FABP in the blood serum of children in groups first, second and third was significantly different from the I-FABP content in the control group at 3, 4 and 7 times (p <0.01). Thus, the serum I-FABP value of ≥ 727.50 pg / ml allows to identify NEC in premature babies at early stages of the disease, even before the clinical manifestation of NEC.