Sharmila Babu1, Malavika Prasad2, Malki Miller1, Mark Morrissey3, Alok Bhutada1, Mary Rojas1, Shantanu Rastogi4,5. 1. Maimonides Medical Center, Maimonides Infant and Children's Hospital, 4802 Tenth Ave, F-119, Brooklyn, NY, 11219, USA. 2. Morgan Stanley Children's Hospital of New York, Columbia University, New York, NY, USA. 3. Wadsworth Center, NYS DOH, Albany, NY, USA. 4. Maimonides Medical Center, Maimonides Infant and Children's Hospital, 4802 Tenth Ave, F-119, Brooklyn, NY, 11219, USA. srastogi@maimonidesmed.org. 5. Department of Pediatrics, SUNY-HSC at Brooklyn, Brooklyn, NY, USA. srastogi@maimonidesmed.org.
Abstract
PURPOSE: Necrotizing enterocolitis (NEC), a leading cause of mortality and morbidity in preterm neonates, lacks a reliable biomarker. Citrulline is primarily produced by enterocytes and correlates with intestinal function. Serum citrulline concentration (CIT) is routinely measured in routine newborn screening (NBS). The purpose of the study is to test if CIT from NBS may predict the occurrence of NEC and whether it correlates with the time to full feeds (TTFF) and length of stay (LOS), serving as a biomarker of NEC and intestinal health. METHODS: In a retrospective case control study conducted on neonates with gestational age of 26-32 weeks, we compared CIT levels between cases (neonates with NEC) and controls (next-born neonate). NBS was collected within first 24 h, at day 5 and when the neonates achieved full feeds and were compared using non-parametric tests. RESULTS: There was no difference in CIT between the controls and cases on day 1 [11.42 (7.42-14.84 vs. 11.93 (6.85-18.8) µmol/L, p = 0.55], on day 5 [11.99 (7.99-16.55) vs. 13.70 (7.42-26.83) µmol/L, p = 0.05], or at full feeds [14.86 (6.85-25.69) vs. 15.7 (7.42-26.26) µmol/L, p = 0.87]. CIT on day 1 did not correlate with TTFF (r = 0.08, p = 0.53) or LOS (r = 0.23, p = 0.06), respectively). CONCLUSIONS: CIT from routine NBS does not serve as a biomarker to predict NEC in preterm neonates.
PURPOSE:Necrotizing enterocolitis (NEC), a leading cause of mortality and morbidity in preterm neonates, lacks a reliable biomarker. Citrulline is primarily produced by enterocytes and correlates with intestinal function. Serum citrulline concentration (CIT) is routinely measured in routine newborn screening (NBS). The purpose of the study is to test if CIT from NBS may predict the occurrence of NEC and whether it correlates with the time to full feeds (TTFF) and length of stay (LOS), serving as a biomarker of NEC and intestinal health. METHODS: In a retrospective case control study conducted on neonates with gestational age of 26-32 weeks, we compared CIT levels between cases (neonates with NEC) and controls (next-born neonate). NBS was collected within first 24 h, at day 5 and when the neonates achieved full feeds and were compared using non-parametric tests. RESULTS: There was no difference in CIT between the controls and cases on day 1 [11.42 (7.42-14.84 vs. 11.93 (6.85-18.8) µmol/L, p = 0.55], on day 5 [11.99 (7.99-16.55) vs. 13.70 (7.42-26.83) µmol/L, p = 0.05], or at full feeds [14.86 (6.85-25.69) vs. 15.7 (7.42-26.26) µmol/L, p = 0.87]. CIT on day 1 did not correlate with TTFF (r = 0.08, p = 0.53) or LOS (r = 0.23, p = 0.06), respectively). CONCLUSIONS:CIT from routine NBS does not serve as a biomarker to predict NEC in preterm neonates.
Entities:
Keywords:
Biomarker; Citrulline; Necrotizing enterocolitis; Newborn screen; Tandem mass spectroscopy
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