I-FABP and fecal calprotectin in necrotizing enterocolitis in newborns: A prospective clinical study

Abstract

Objective. To evaluate the diagnostic and prognostic value of I-FABP (in serum and urine) and fecal calprotectin as biomarkers for the early diagnosis of necrotizing enterocolitis (NEC) in newborns. Materials and methods. A prospective study involving 42 newborns was conducted. The main group included 12 newborns with a confirmed NEC diagnosis. The comparison group included 18 newborns with intestinal symptoms without NEC. The control group consisted of 12 healthy newborns. The levels of I-FABP in serum and urine, as well as fecal calprotectin, were measured in all the subjects. Receiver Operating Characteristic (ROC) analysis was used to assess the diagnostic accuracy of the markers by calculating the area under the curve (AUC), sensitivity, and specificity. Results. Levels of serum I-FABP, urinary I-FABP, and fecal calprotectin in NEC patients were significantly higher than those in the comparison and control groups (p < 0.001). ROC analysis demonstrated high diagnostic value for each biomarker: serum I-FABP – AUC = 0.91; urinary I-FABP – AUC = 0.76; fecal calprotectin – AUC = 0.86. The combination of the investigated markers showed the highest efficacy, with an AUC of 0.93, a sensitivity of 93.5%, and a specificity of 91.7%. Conclusion. Necrotizing enterocolitis is a life-threatening condition, whose early diagnosis remains challenging. The study results confirm the high informativity of I-FABP and fecal calprotectin as biomarkers of intestinal injury. The combination of these markers demonstrates exceptionally high diagnostic accuracy (sensitivity 93.5%, specificity 91.7%), supporting their use in clinical practice to improve the early diagnosis and management of NEC patients.