Urine-based detection of intestinal mucosal cell damage in neonates with suspected necrotizing enterocolitis

Objectives To assess the diagnostic value of the urinary intestinal fatty acid-binding protein (iFABP) in neonatal necrotizing enterocolitis (NEC) in the early stage of the disease. Background NEC is a severe acute gastrointestinal disease affecting preterm newborns. iFABP has been associated with injury to the intestinal mucosa common to NEC. Patients and methods This cross-sectional study included 40 preterm neonates divided into two groups: group I included 20 preterm neonates with suspected NEC according to Modified Bell Staging Criteria for NEC and group II included 20 preterm neonates with non-NEC. All the included participants underwent full history taking, full examination, routine laboratory investigations, and assessment of urinary iFABP. Results The mean urinary iFABP level was 17.26 ± 3.69 ng/dl in group I and 8.39 ± 2.49 ng/ml in group II. This difference was significantly higher in the suspected NEC group (P = 0.001). The iFABP level at a cutoff more than 9.25 ng/ml had significant power of discrimination of NEC cases at an early stage (P = 0.001) with a sensitivity of 96.0% and specificity of 71.0%. Linear regression revealed that the sampling time was a significant measure for prediction of iFABP (P = 0.001). Conclusion There was an association between elevated iFABP levels in urine and NEC, suggesting that iFABP may be useful as a diagnostic biomarker for earlier identification of NEC.