P0137 / #1413: A NEW MARKER FOR THE ASSESSMENT OF NUTRITION OF CRITICALLY ILL CHILDREN: ZONULIN

Abstract

Aims & Objectives: We aimed to evaluate how serum zonulin level is affected and to assess the correlation with biochemical parameters of prealbumin and vitamin D in patients admitted to the pediatric intensive care unit. Methods: The study included 35 critically-ill-pediatric patients, while the control group comprised 25 healthy volunteer children. Trauma patients and those with active infection were excluded from the study. A cross-sectional, case-controlled study was performed. Results: Serum zonulin level was identified to be statistically significantly high in critically-ill-patients compared to healthy control group. There was a correlation identified between zonulin and prealbumin. When prealbumin was high, zonulin was high, and when prealbumin was low, zonulin was low. Elevated zonulin was correlated with low vitamin D levels.Conclusions: The identification of high zonulin levels in critically-ill-pediatric patients compared to healthy control group may be linked to delayed gastric emptying, development of abnormal motility patterns, disrupted intestinal barrier, lengthened catabolic process, exposure to oxidative and hypoxic stress and linked to all of this, developing bacterial translocation. Due to the identification of lower-than-expected zonulin levels examined simultaneous to low prealbumin values, it is considered that it cannot be used for assessment of acute malnutrition. There is a need for studies including higher patient numbers and involving repeated measurements to more clearly show the correlation between nutrition and zonulin level. This study is important as the first study in the literature to measure serum zonulin levels for assessment of nutrition in critical pediatric patients.