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Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study

  • Original Article—Alimentary Tract
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Abstract

Background

Intestinal fatty acid-binding protein (I-FABP) is a low-molecular-mass (15 kDa) cytosolic protein found exclusively in the epithelial cells of the small bowel mucosa. We aimed to evaluate the clinical usefulness of serum I-FABP measurement for the diagnosis of ischemic small bowel disease.

Methods

Patients with a clinical diagnosis of acute abdomen were recruited for this multicenter trial at one university hospital and nine city hospitals over a 13-month period. Serum I-FABP levels were measured in 361 eligible patients by an enzyme-linked immunosorbent assay using a specific monoclonal antibody.

Results

Of the 361 patients, 242 underwent surgery, and small bowel ischemia was diagnosed in 52 patients. The mean serum I-FABP level in the patients with small bowel ischemia was 40.7 ± 117.9 ng/ml, which was significantly higher than that in patients with non-ischemic small bowel disease (5.8 ± 15.6 ng/ml) and those with non-small bowel disease (1.8 ± 1.7 ng/ml). The serum I-FABP cutoff level for the diagnosis of small bowel ischemia was 3.1 ng/ml. Serum I-FABP was more efficient than conventional biochemical markers, in terms of sensitivity and positive and negative predictive values, in the diagnosis of small bowel ischemia. However, its specificity was slightly lower than that of creatinine phosphokinase or lactate dehydrogenase. The positive and negative likelihood ratios of serum I-FABP were 3.01 and 0.29, respectively.

Conclusion

Serum I-FABP measurement is a non-invasive method that is potentially useful for the efficient identification of patients with acute abdomen who are at risk of small bowel ischemia.

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Acknowledgments

We wish to thank Dr. K. Akazawa, Professor of the Division of Information Science and Biostatistics, Niigata University Graduate School of Medical and Dental Sciences, for helpful advice on statistical analysis.

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Authors and Affiliations

  1. Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Niigata, 951-8510, Japan

    Tatsuo Kanda, Tatsuo Tani & Katsuyoshi Hatakeyama

  2. Department of Surgery, Niigata Prefecture Shibata Hospital, Shibata, Japan

    Akihiro Tsukahara

  3. Department of Surgery, Kariwagun General Hospital, Kashiwazaki, Japan

    Kyo Ueki

  4. Department of Surgery, Saiseikai Niigata Daini Hospital, Niigata, Japan

    Yasuo Sakai

  5. Department of Surgery, Nagaoka Chuo General Hospital, Nagaoka, Japan

    Atsushi Nishimura

  6. Department of Surgery, Niigata City General Hospital, Niigata, Japan

    Toshiyuki Yamazaki

  7. Department of Surgery, Niigata Prefecture Yoshida Hospital, Tsubame, Japan

    Yoichi Tamiya

  8. Department of Surgery, Tachikawa General Hospital, Nagaoka, Japan

    Tetsuya Tada

  9. Department of Surgery, Niigata Prefecture Muikamachi Hospital, Minamiuonuma, Japan

    Masaki Hirota

  10. Department of Surgery, Japanese Red Cross Nagaoka Hospital, Nagaoka, Japan

    Jun Hasegawa

  11. DS Pharma Biomedical Co., Ltd., Osaka, Japan

    Hiroyuki Funaoka

  12. Department of Bioscience and Biotechnology, Shinshu University, Nagano, Japan

    Hiroshi Fujii

Authors
  1. Tatsuo Kanda
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  2. Akihiro Tsukahara
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  3. Kyo Ueki
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  4. Yasuo Sakai
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  5. Tatsuo Tani
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  6. Atsushi Nishimura
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  7. Toshiyuki Yamazaki
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  8. Yoichi Tamiya
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  9. Tetsuya Tada
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  10. Masaki Hirota
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  11. Jun Hasegawa
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  12. Hiroyuki Funaoka
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  13. Hiroshi Fujii
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  14. Katsuyoshi Hatakeyama
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Corresponding author

Correspondence to Tatsuo Kanda.

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Kanda, T., Tsukahara, A., Ueki, K. et al. Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study. J Gastroenterol 46, 492–500 (2011). https://doi.org/10.1007/s00535-011-0373-2

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  • DOI: https://doi.org/10.1007/s00535-011-0373-2

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