José Luis Gómez-Chaparro Moreno1, Alejandro Rodríguez Torronteras2, María Dolores Ruiz González3, Lucía Izquierdo Palomares4, Daniel Bonilla Valverde5, Julia Ruiz Laguna5, Alfonso Delgado Rubio6, Juan López-Barea5. 1. Experimental Unit. Córdoba Health District. Andalusian Health Service, C/ Isla de Lanzarote s/n Edificio 2, 1ª Planta, 14011, Córdoba, Spain. b22gomoj@uco.es. 2. Department of Epidemiology. Córdoba Health District, Andalusian Health Service, C/ Isla de Lanzarote s/n Edificio 2, 1ª Planta, Córdoba, 14011, Spain. 3. Neonatology Unit, Pediatrics Service, RSUH. Andalusian Health Service, Avda. Menendez Pidal s/n., Córdoba, 14004, Spain. 4. Pediatrics Radiology Section, Radiodiagnostic Service, RSUH, Andalusian Health Service, Avda. Menendez Pidal s/n., Córdoba, 14004, Spain. 5. Department of Biochemistry and Molecular Biology of Córdoba University, Severo Ochoa Building. A4 Highway, Km 396a, Rabanales Campus, Córdoba, 14071, Spain. 6. Department of Pediatric of San Pablo-CEU University, School of Medicine. Monteprincipe Campus. Alcorcón, Madrid, 28925, Spain.
Abstract
UNLABELLED: We aimed to establish the utility of serum cytosolic β-glycosidase (CBG) assay as a NEC diagnosis tool. CBG activity has been compared in 192 NEC-free (NEC(-)) and 13 NEC-affected (NEC(+)) neonates, with modified Bell's stages II/III, born at Reina Sofia University Hospital; additional blood hematology, microbiology, and biochemical parameters have been assayed. NEC(+) neonates have higher serum CBG activity, 26.4 ± 12.4 mU/mg; 95 % CI (18.8-33.9), than NEC(-) infants, 11.0 ± 6.6 mU/mg; 95 % CI (10.1-11.9) (p < 0.0001). The CBG cutoff value in the ROC curve, 15.6 mU/mg, discriminates NEC(+)/NEC(-) infants with 84.6 % sensitivity, 85.9 % specificity, 37.9 positive predictive value and 98.2 negative predictive value, 6.11 positive likelihood ratio and 0.18 negative likelihood ratio, 33.61 DOR, and 0.89 AUC. A combined panel [CBG + aspartate aminotransferase + C-reactive protein] shows a 0.90 AUC value in multiple linear regressions. CONCLUSIONS: The serum CBG level is a good NEC diagnosis test and a novel NEC biomarker which may become a screening tool. WHAT IS KNOWN: •NEC affects ∼2.5 % of infants at NICU, ∼90 % of them weighing <1500 g. •NEC requires a careful differential diagnosis, being lethal if not diagnosed and treated. What is new: •CBG assay will be useful to determine infants without NEC and preventing unnecessary treatment. •CBG assay could discriminate NEC better than other gut-specific sera protein biomarkers.
UNLABELLED: We aimed to establish the utility of serum cytosolic β-glycosidase (CBG) assay as a NEC diagnosis tool. CBG activity has been compared in 192 NEC-free (NEC(-)) and 13 NEC-affected (NEC(+)) neonates, with modified Bell's stages II/III, born at Reina Sofia University Hospital; additional blood hematology, microbiology, and biochemical parameters have been assayed. NEC(+) neonates have higher serum CBG activity, 26.4 ± 12.4 mU/mg; 95 % CI (18.8-33.9), than NEC(-) infants, 11.0 ± 6.6 mU/mg; 95 % CI (10.1-11.9) (p < 0.0001). The CBG cutoff value in the ROC curve, 15.6 mU/mg, discriminates NEC(+)/NEC(-) infants with 84.6 % sensitivity, 85.9 % specificity, 37.9 positive predictive value and 98.2 negative predictive value, 6.11 positive likelihood ratio and 0.18 negative likelihood ratio, 33.61 DOR, and 0.89 AUC. A combined panel [CBG + aspartate aminotransferase + C-reactive protein] shows a 0.90 AUC value in multiple linear regressions. CONCLUSIONS: The serum CBG level is a good NEC diagnosis test and a novel NEC biomarker which may become a screening tool. WHAT IS KNOWN: •NEC affects ∼2.5 % of infants at NICU, ∼90 % of them weighing <1500 g. •NEC requires a careful differential diagnosis, being lethal if not diagnosed and treated. What is new: •CBG assay will be useful to determine infants without NEC and preventing unnecessary treatment. •CBG assay could discriminate NEC better than other gut-specific sera protein biomarkers.
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