Abstract | OBJECTIVES: Postabsorptive plasma citrulline concentration has been proposed as a reliable marker of small bowel absorptive capacity in short bowel patients. The aim of this study was to address the potentially confounding impact of intestinal inflammation. METHODS: Fifty-five patients were selected according to diagnosis, small bowel length, and degree of bowel inflammation. (a) Crohn's disease (CD) with massive small bowel resection leaving </=50 cm (N = 6), (b) CD with 50-150 cm remaining (N = 9), (c) CD with no resection but active inflammation (high C-reactive protein [CRP] and Crohn's Disease Activity Index [CDAI] >220) (N = 7), (d) CD without resection or active inflammation (normal CRP and CDAI <150) (N = 9), (e) mesenteric infarction (MI) with resection leaving </=50 cm (N = 6), (f) MI leaving 50-150 cm (N = 6), (g) active celiac disease (N = 6), (h) healthy volunteers (N = 6). Postabsorptive fasting plasma citrulline was measured using reverse-phase, high performance liquid chromatography. Absorptive capacity and permeability were also measured after oral sugar-mix ingestion (5 g lactulose, 1 g L- rhamnose, 0.5 g D-xylose). RESULTS: The plasma citrulline strongly correlated with small bowel length (P < 0.0001) and xylose absorption (P < 0.001). No correlation was found with CDAI, permeability, CRP, albumin, sedimentation rate, white cell count, or platelet count. Citrulline was significantly higher (P < 0.0004) in CD and MI patients with a remnant small bowel length of 50-150 cm (mean 21.0 micromol/L) than in those with length </=50 cm (mean 9.2 micromol/L). CONCLUSIONS: Plasma citrulline concentration is a simple and reliable surrogate for small bowel absorptive capacity and is not influenced by intestinal inflammation.
|
Authors | Cinzia Papadia, Roy A Sherwood, Chrysostomos Kalantzis, Katharina Wallis, Umberto Volta, Erica Fiorini, Alastair Forbes |
Journal | The American journal of gastroenterology
(Am J Gastroenterol)
Vol. 102
Issue 7
Pg. 1474-82
(Jul 2007)
ISSN: 0002-9270 [Print] United States |
PMID | 17459021
(Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Albumins
- Biomarkers
- Drug Combinations
- Citrulline
- Lactulose
- C-Reactive Protein
- Xylose
- Rhamnose
|
Topics |
- Administration, Oral
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Albumins
(metabolism)
- Biomarkers
(blood)
- Blood Sedimentation
- C-Reactive Protein
(metabolism)
- Chromatography, High Pressure Liquid
- Citrulline
(blood)
- Drug Combinations
- Female
- Follow-Up Studies
- Humans
- Inflammatory Bowel Diseases
(blood, surgery, urine)
- Intestinal Absorption
(physiology)
- Lactulose
(administration & dosage)
- Laparotomy
- Leukocyte Count
- Male
- Middle Aged
- Platelet Count
- Prognosis
- ROC Curve
- Retrospective Studies
- Rhamnose
(administration & dosage)
- Severity of Illness Index
- Xylose
(administration & dosage)
|