Ebenau, Jarith (2012) Fecale galzouten: voorspellend voor necrotiserende enterocolitis? thesis, Medicine.
Full text available on request.Abstract
Introduction: Necrotising enterocolitis (NEC) is an acute gastrointestinal disease that predominantly affects preterm infants and is an important cause of morbidity and mortality. The cause of this disease remains unknown. In vivo animal experiments have shown that intestinal bile salts may play a role in the pathophysiology of NEC. To date, bile salt data of human preterm infants with NEC are lacking. In this report we determined the value of fecal bile salts as a (predictive) marker for NEC. Furthermore, we analysed the effect of prebiotics on fecal bile salts and the relationship of bile salts with 2 ‘fecal’ markers of inflammation, i.e. interleukin-8 (IL-8) and calprotectin. Material and method: The cohort consisted of infants with a gestational age of < 32 weeks and birth weight < 1500 gram. Bile salts were measured in fecal specimens of infants, whose demographic, clinical and laboratory data (potential administration of prebiotics, calprotectin and IL-8 concentration) was already known. Diapers were collected at 4 days (day 1, 7, 14 and 30). Results: There were 110 usable fecal samples; 11 samples before diagnosis, 3 samples after diagnosis and 96 samples of infants without NEC. NEC was diagnosed at a median age of 20,5 days (range 6-60). In the feces we found the bile salts deoxycholate, cholate, chenodeoxycholate, hyodeoxcycholate and hyocholate. There was a significant decrease of 66% in total fecal bile salt concentrations between day 7 and 14 (p = 0,002). Between infants with and without (developing) NEC, the concentrations of the total and specific bile salts were not significantly different. Fecal bile salt concentrations of preterm infants with and without prebiotics were similar. There was no significant relationship between fecal bile salts and IL-8 or calprotectin. Conclusion: Fecal bile salt concentration decreases in the first 14 days postnatally. In this small group there was no difference in fecal bile salt concentration between preterm infants with and without NEC. The final utility of bile salts as marker for NEC has to be defined in a larger cohort.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Hulzebos, Dr. C.V. kinderarts-neonatoloog Beatrix Kinderklin |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:01 |
| Last Modified: | 25 Jun 2020 11:01 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2120 |
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