Plasma Citrulline Level In Preterm Neonates With Necrotizing Enterocolitis

Abstract

Abstract Background Necrotizing enterocolitis is 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. Objective of the study is to test if Citrulline can be used as a biomarker of NEC and serving as a biomarker for intestinal recovery. Subjects This is a case control study, Plasma citrulline levels of neonates with a gestational age <35 weeks and 2000 gram who developed NEC were measured, comparing it to properly gestational age and weight matched pretrem neonates. Patients and methods sixty neonates were classified into two groups: the patients group which included 30 neonates with confirmed NEC and the control group which included 30 healthy preterm neonates. Results Plasma citrulline level was significantly lower in the patients group than in the control group With Median citrulline levels of NEC and control groups were 2 and 20 μmol/l respectively (P < 0.0001), with a sensitivity of 86.7%, specificity of 93.3% and cut off level of citrulline was ≤11μmol/l for diagnosis. Conclusion Plasma citrulline level is a very good non invasive marker for NEC diagnosis.