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Citrulline as a biomarker of short bowel syndrome in children
- Authors: Marakhouski K.Y.1, Svirsky A.A.1, Makhlin A.M.1, Shmeleva N.D.1, Kuvaeva Z.I.2, Korzuk E.B.2
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Affiliations:
- Republican scientific and practical center of pediatric surgery
- Institute of physical and organic chemistry of the National Academy of Sciences of Belarus
- Issue: Vol 9, No 4 (2019)
- Pages: 35-42
- Section: Original Study Articles
- Submitted: 21.04.2020
- Accepted: 21.04.2020
- Published: 22.12.2019
- URL: https://rps-journal.ru/jour/article/view/618
- DOI: https://doi.org/10.30946/2219-4061-2019-9-4-35-42
- ID: 618
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Abstract
Purpose. To determine the diagnostic significance of blood citrulline level when estimating the short bowel syndrome (SBS) in children under 5 years old. To determine the blood citrulline level in children of different age. Methods. The examined group (N=31) included children under 5 who underwent small or small and large intestine resection and developed (15 children) or not developed (16 children) clinical signs of SBS. The control group included children who underwent no surgery on the GIT and had no congenital malformations and clinical signs of enteropathy (N=42). To determine the level of citrulline, overpressured high performance liquid column chromatography was used. Statistical analysis of the results was done with MedCalc® version 18.11.3. Results. Mean level of blood citrulline is 28.9 µmol/l in the examined group (95% CI 23.2–34.6) and 30.5 µmol/l in the control group (95% CI 25.0–35.1). Reliable data of the ratio between blood level citrulline and age of the child were obtained both among operated and non-operated children. The odds ratio of determining citrulline in blood was below 24.4 µmol/l in development of SBS clinical picture and amounted to 4.08 р < 0,05. Additional use of ROC analysis confirms the presence of interrelation between citrulline level and absence or presence of SBS clinical signs with 100% specificity and 43% sensitivity. The area under curve (categorical variable showing whether SBS is present or lacking) is 0,746, р = 0,005. Conclusion. Determination of serum citrulline as a diagnostic marker of short bowel syndrome in children under 5 found low sensitivity but high specificity. Thus, blood citrulline index can be used as a biomarker to diagnose SBS, to describe the course of SBS in detail and determine the risk of severe forms of this pathology in children under 5.
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About the authors
K. Y. Marakhouski
Republican scientific and practical center of pediatric surgery
Author for correspondence.
Email: kmarakh@tut.by
ORCID iD: 0000-0002-4191-6053
Kirill Y. MARAKHOVSKI – Cand. Sci. (Med.), highest category endoscopist, Head of diagnostic division
Nezavisimosti ave., 64, Minsk, 220013
БелоруссияA. A. Svirsky
Republican scientific and practical center of pediatric surgery
Email: fake@neicon.ru
ORCID iD: 0000-0001-6323-6537
Alexander A. SVIRSKY – Cand. Sci. (Med.), associate professor, highest category pediatric surgeon, Deputy Director in medical treatment
Nezavisimosti ave., 64, Minsk, 220013
БелоруссияA. M. Makhlin
Republican scientific and practical center of pediatric surgery
Email: fake@neicon.ru
Alexander М. MAKHLIN – Highest category pediatric surgeon, surgical department No.3
Nezavisimosti ave., 64, Minsk, 220013
БелоруссияN. D. Shmeleva
Republican scientific and practical center of pediatric surgery
Email: fake@neicon.ru
ORCID iD: 0000-0002-8594-5278
Natalia D. SHMELEVA – Highest category epidemiologist, researcher, Department of Science
Nezavisimosti ave., 64, Minsk, 220013
БелоруссияZ. I. Kuvaeva
Institute of physical and organic chemistry of the National Academy of Sciences of Belarus
Email: fake@neicon.ru
Zoya I. KUVAEVA – Dr. Sci. (Med.), Professor, Head of Medicinal Substances Department
Surganova, 13, Minsk, 220072
БелоруссияE. B. Korzuk
Institute of physical and organic chemistry of the National Academy of Sciences of Belarus
Email: fake@neicon.ru
Ekaterina B. KORZUK – Junior research assistant, Medicinal Substances Department
Surganova, 13, Minsk, 220072
БелоруссияReferences
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