Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia
Alexandre Nuzzo, Kévin Guedj, Sonja Curac, Claude Hercend, Claude Bendavid, Nathalie Gault, Alexy Tran‐Dinh, Maxime Ronot, Antonino Nicoletti, Yoram Bouhnik, Yves Castier, Olivier Corcos, Katell Peoc’h, Audrey Huguet, Carmen Stéfanescu, Xavier Treton, Francisca Joly, Lore Billiauws, A. Hamon, Auréline Boitet, Céline Lekhal, David Deutsch, Elsa Oiknin, Laura Cohen, Gabriel Marcellier, Jean Sénémaud, Félix Corre, Damien Soudan, Cosmin Sebastian Voican, Jean-Baptiste Leclère, Jules Iquilles, Lucas Raynaud, Luisa Paulatto, Manon Haas, Mathieu Uzzan, Mathilde Cohen, Sara Tadbiri, Servane Prevot, Yves Panís, Alice Frontali, Simon Msika, Lara Kelly Ribeiro, Lionel Rebibo, Konstantinos Arapis, Marion Orville, Annie Sibert, P. Copin, Magaly Zappa, Marco Dioguardi Burgio, Valérie Vilgrain, Caroline Bertin, Anne Kerbaol, Wassim Allaham, Quentin Pellenc, Arnaud Roussel, Pierre Cerceau, Iannis Ben Abdallah, Antoine Girault, Pierre Mordant, Romain de Blic, Cathérine Paugam‐Burtz, Emmanuel Weiss, Paër-Sélim Abback, I. Enriquez, Sylvie Janny, Hélène Bout, Mikhaël Giabicani, Marina Achouf, Bénédicte Grigoresco, Linda Koy Ear, Sonja Curac, Agnès Cachier, Aurélie Plessier, Pierre‐Emmanuel Rautou, Dominique Valla, Audrey Payancé, Alain Sauvanet, Safi Dokmak, F. Dondéro, Ailton Sepulveda, Olivier Farges, Béatrice Aussilhou, Bénédicte Jaïs, Dominique Cazals‐Hatem, Emmanuelle de Raucourt, Larbi Boudaoud, Catherine Trichet, Hervé Puy, Nathalie Pons‐Kerjean, Jeanick Stocco, J. Bataille, Valérie Bouton, Philippe Montravers, Pascal Augustin, Brice Lortat Jacob, Jean-Baptiste Michel, Dominique Gauguier, Marc‐Emmanuel Dumas, François Brial, Antonis Myridakis
Abstract
Early diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI-citrulline, intestinal fatty acid-binding protein (I-FABP), and D-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients-50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 μmol/L (12.0-26.0) vs. 23.3 μmol/L (18.3-29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58-0.78). No statistical difference was found in plasma I-FABP and plasma D-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and D-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.