The role of fecal short-chain fatty acids in neonatal necrotizing enterocolitis.

Background: The metabolites of microbiota may contribute to the pathogenesis of neonatal necrotizing enterocolitis (NEC). The aim of this study was to explore the role of fecal short-chain fatty acids (SCFAs) in the development and progression of NEC.

Methods: This study was a retrospective case-control study. The included infants with NEC and non-NEC infants who were hospitalized during the same period were classified into the NEC and control groups, respectively. The concentrations of SCFAs were measured by chromatography-mass spectrometry analysis. The clinical data and concentrations of SCFAs were compared between the NEC and control groups. The association between clinical data, concentrations of SCFAs, and levels of C-reactive protein (CRP) and procalcitonin (PCT) was assessed by Spearman correlation analysis and multivariate linear regression analysis. The predictive values of factors with statistical significance were assessed by receiver operator characteristic curve.

Results: Twenty-one infants with NEC and 27 non-NEC infants were included in our study. Propionic acid and butyric acid were positively correlated with the incidence of NEC, while isobutyric acid, valeric acid, isocaproic acid, and caproic acid were negatively correlated with the incidence of NEC. Propionic acid concentrations were positively correlated with levels of CRP and PCT. Birth weight, gestational age, isobutyric acid, isocaproic acid, caproic acid, and valeric acid concentrations were negatively correlated with the levels of PCT. Increased propionate acid concentration and decreased butyric acid concentration were risk factors for increased PCT. The decreased level of valeric acid was an independent risk factor for the occurrence of NEC.

Conclusions: Certain SCFAs were associated with the development and progression of NEC.