Early Diagnosis of Intestinal Ischemia Using Urinary and Plasma Fatty Acid Binding Proteins
Abstract
OBJECTIVE: This study aims at improving diagnosis of intestinal ischemia, by measuring plasma and urinary fatty acid binding protein (FABP) levels. METHODS: Fifty consecutive patients suspected of intestinal ischemia were included and blood and urine were sampled at time of suspicion. Plasma and urinary concentrations of intestinal FABP (I-FABP), liver FABP (L-FABP) and ileal bile acid binding protein (I-BABP) were measured using enzyme-linked immunosorbent assays. RESULTS: Twenty-two patients suspected of intestinal ischemia were diagnosed with intestinal ischemia, 24 patients were diagnosed with other diseases, and 4 patients were excluded from further analysis fulfilling exclusion criteria. Median plasma concentrations of I-FABP and L-FABP and urinary concentrations of all 3 markers were significantly higher in patients with proven intestinal ischemia than in patients suspected of intestinal ischemia with other final diagnoses (plasma I-FABP; 653 pg/mL vs. 109 pg/mL, P = 0.02, plasma L-FABP; 117 ng/mL vs. 25 ng/mL, P = 0.006, urine I-FABP; 3377 pg/mL vs. 115 pg/mL, P = 0.001, urine L-FABP; 1,199 ng/mL vs. 37 ng/mL, P =0.004, urine I-BABP; 48.6 ng/mL vs. 0.6 ng/mL, P = 0.002). Positive and negative likelihood ratios significantly increased positive posttest probability and decreased negative posttest probability on intestinal ischemia. In patients with intestinal ischemia a trend to higher plasma I-BABP levels was observed when the ileum was involved (18.4 ng/mL vs. 2.9 ng/mL, P = 0.05). CONCLUSION: Plasma and especially urinary I-FABP and L-FABP levels and urinary I-BABP levels can improve early diagnosis of intestinal ischemia. Furthermore, plasma I-BABP levels can help in localizing ileal ischemia.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Serum L-FABP had sensitivity 59% and specificity 88% in a single study.
“Serum L-FABP (59 and 88%, respectively) [75].”
From Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis (2023) · cites this paper as [75]
Urinary intestinal ileal bile acid binding protein had sensitivity 70% and specificity 89% in a single study.
“Urinary I-BABP (70 and 89%) [75].”
From Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis (2023) · cites this paper as [75]
Serum intestinal ileal bile acid binding protein had sensitivity 64% and specificity 63% in a single study.
“Serum I-BABP (64 and 63%) [75].”
From Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis (2023) · cites this paper as [75]
Urinary L-FABP had sensitivity 80% and specificity 78% in a single study.
“Urinary L-FABP (80 and 78%) [75].”
From Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis (2023) · cites this paper as [75]
Cites
The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration
Bossuyt, P. M., Reitsma, J. B., Bruns, D. E., Gatsonis, C. A., Glasziou, P., Irwig, L., Moher, D., Rennie, D., de Vet, H. C. W., & Lijmer, J. G. (2003) · Clinical Chemistry · doi:10.1373/49.1.7 · Cited by 1,124 · see citing works
Acute Mesenteric Ischemia: A Clinical Review
Oldenburg, W. A., Lau, L. L., Rodenberg, T. J., Edmonds, H. J., & Burger, C. D. (2004) · Archives of Internal Medicine · doi:10.1001/archinte.164.10.1054 · Cited by 714 · see citing works
Pelsers, M. M. A. L., Namiot, Z., Kisielewski, W., Namiot, A., Januszkiewicz, M., Hermens, W. T., & Glatz, J. F. C. (2003) · Clinical Biochemistry · doi:10.1016/s0009-9120(03)00096-1 · Cited by 377 · see citing works
Kougias, P., Lau, D., El Sayed, H. F., Zhou, W., Huynh, T. T., & Lin, P. H. (2007) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2007.04.045 · Cited by 303 · see citing works
CT Diagnosis of Acute Mesenteric Ischemia from Various Causes
Furukawa, A., Kanasaki, S., Kono, N., Wakamiya, M., Tanaka, T., Takahashi, M., & Murata, K. (2009) · American Journal of Roentgenology · doi:10.2214/ajr.08.1138 · Cited by 300 · see citing works
Kanda, T., Fujii, H., Tani, T., Murakami, H., Suda, T., Sakai, Y., Ono, T., & Hatakeyama, K. (1996) · Gastroenterology · doi:10.1053/gast.1996.v110.pm8566578 · Cited by 283 · see citing works
Evennett, N. J., Petrov, M. S., Mittal, A., & Windsor, J. A. (2009) · World Journal of Surgery · doi:10.1007/s00268-009-0074-7 · Cited by 270 · see citing works
Lieberman, J. M., Sacchettini, J. C., MARKS, C., & Marks, W. H. (1997) · Surgery · doi:10.1016/s0039-6060(97)90363-9 · Cited by 217 · see citing works
Review article: diagnosis and management of mesenteric ischaemia with an emphasis on pharmacotherapy
Kozuch, P. L., & Brandt, L. J. (2005) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2005.02269.x · Cited by 175 · see citing works
Lock, G. (2001) · Best Practice & Research Clinical Gastroenterology · doi:10.1053/bega.2000.0157 · Cited by 148 · see citing works
Maatman, R. G. H. J., van de Westerlo, E. M. A., Kuppevelt, T. H. M. S. M. V., et al. (1992) · Biochemical Journal · doi:10.1042/bj2880285 · Cited by 143 · see citing works
EVIDENCE FOR INTESTINAL AND LIVER EPITHELIAL CELL INJURY IN THE EARLY PHASE OF SEPSIS
Derikx, J. P. M., Poeze, M., van Bijnen, A. A. J. H. M., Buurman, W. A., & Heineman, E. (2007) · Shock · doi:10.1097/shk.0b013e3180644e32 · Cited by 138 · see citing works
Self-citationGollin, G., MARKS, C., & Marks, W. H. (1993) · PubMed · Cited by 129 · see citing works
Derikx, J. P. M., Matthijsen, R. A., A, A. P. D. B., van Bijnen, A. A. J. H. M., Heineman, E., van Dam, R. M., Dejong, C. H. C., & Buurman, W. A. (2008) · PLoS ONE · doi:10.1371/journal.pone.0003428 · Cited by 126 · see citing works
Self-citationDerikx, J. P. M., Vreugdenhil, A. C. E., den Neucker, A. M. V., Grootjans, J., van Bijnen, A. A. J. H. M., Damoiseaux, J. G. M. C., van Heurn, E. L. W., Heineman, E., & Buurman, W. A. (2009) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e31819194b0 · Cited by 123 · see citing works
Self-citationvan de Poll, M. C. G., Derikx, J. P. M., Buurman, W. A., Peters, W. H. M., Roelofs, H. M. J., Wigmore, S. J., & Dejong, C. H. C. (2007) · World Journal of Surgery · doi:10.1007/s00268-007-9182-4 · Cited by 122 · see citing works
Self-citationCronk, D. R., Houseworth, T. P., Cuadrado, D. G., Herbert, G. S., McNutt, P. M., & Azarow, K. S. (2006) · Current Surgery · doi:10.1016/j.cursur.2006.05.006 · Cited by 105 · see citing works
Hanssen, S. J., Derikx, J. P. M., Windsant, I. C. V., Heijmans, J. H., Koeppel, T. A., Schurink, G. W. H., Buurman, W. A., & Jacobs, M. J. H. M. (2008) · Annals of Surgery · doi:10.1097/sla.0b013e3181784cc5 · Cited by 94 · see citing works
Self-citationDerikx, J. P. M., Evennett, N. J., Degraeuwe, P. L. J., et al. (2007) · Gut · doi:10.1136/gut.2007.128934 · Cited by 94 · see citing works
Self-citationAcute bowel ischemia: CT findings
Angelelli, G., Scardapane, A., Memeo, M., Ianora, A. A. S., & Rotondò, A. (2004) · European Journal of Radiology · doi:10.1016/j.ejrad.2003.11.013 · Cited by 78 · see citing works
Derikx, J. P. M., Blijlevens, N. M. A., Donnelly, J. P., Fujii, H., Kanda, T., van Bijnen, A. A. J. H. M., Heineman, E., & Buurman, W. A. (2008) · Annals of Oncology · doi:10.1093/annonc/mdn579 · Cited by 60 · see citing works
Self-citationImmunohistochemical Distribution of Intestinal 15 kDa Protein in Human Tissues.
Watanabe, K., Hoshi, N., Tsuura, Y., et al. (1995) · Archivum histologicum japonicum · doi:10.1679/aohc.58.303 · Cited by 19 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Intestinal permeability – a new target for disease prevention and therapy
Bischoff, S. C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J.-D., Serino, M., Tilg, H., Watson, A., & Wells, J. M. (2014) · BMC Gastroenterology · doi:10.1186/s12876-014-0189-7 · Cited by 1,755 · see citing works
Self-citationEditor's Choice – Management of the Diseases of Mesenteric Arteries and Veins
Björck, M., Koelemay, M., Acosta, S., Bastos Goncalves, F., Kölbel, T., Kolkman, J. J., Lees, T., Lefevre, J. H., Menyhei, G., Oderich, G., et al. (2017) · European Journal of Vascular and Endovascular Surgery · doi:10.1016/j.ejvs.2017.01.010 · Cited by 658 · see citing works
van Wijck, K., Lenaerts, K., Grootjans, J., Wijnands, K. A. P., Poeze, M., van Loon, L. J. C., Dejong, C. H. C., & Buurman, W. A. (2012) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00066.2012 · Cited by 285 · see citing works
Self-citationThe Diagnosis of Acute Mesenteric Ischemia: A Systematic Review and Meta-analysis
Cudnik, M. T., Darbha, S., Jones, J., Macedo, J., Stockton, S. W., & Hiestand, B. C. (2013) · Academic Emergency Medicine · doi:10.1111/acem.12254 · Cited by 275 · see citing works
Methods to determine intestinal permeability and bacterial translocation during liver disease
Wang, L., Llorente, C., Hartmann, P., Yang, A.-M., Chen, P., & Schnabl, B. (2015) · Journal of Immunological Methods · doi:10.1016/j.jim.2014.12.015 · Cited by 257 · see citing works
Current status on plasma biomarkers for acute mesenteric ischemia
Acosta, S., & Nilsson, T. (2012) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-011-0660-z · Cited by 157 · see citing works
ter Steege, R. W. F., & Kolkman, J. J. (2012) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2011.04980.x · Cited by 145 · see citing works
Treskes, N., Persoon, A. M., & van Zanten, A. R. H. (2017) · Internal and Emergency Medicine · doi:10.1007/s11739-017-1668-y · Cited by 135 · see citing works
Diagnostic performance of plasma biomarkers in patients with acute intestinal ischaemia
Matsumoto, S., Sekine, K., Funaoka, H., Yamazaki, M., Shimizu, M., Hayashida, K., & Kitano, M. (2014) · British Journal of Surgery · doi:10.1002/bjs.9331 · Cited by 135 · see citing works
Markers of intestinal injury are associated with endotoxemia in successfully resuscitated patients
Grimaldi, D., Guivarch, E., Neveux, N., Fichet, J., Pène, F., Marx, J.-S., Chiche, J.-D., Cynober, L., Mira, J.-P., & Cariou, A. (2013) · Resuscitation · doi:10.1016/j.resuscitation.2012.06.010 · Cited by 130 · see citing works
Gastro-Intestinal Vascular Emergencies
Corcos, O., & Nuzzo, A. (2013) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2013.08.006 · Cited by 104 · see citing works
Biochemical markers of acute intestinal ischemia: Possibilities and limitations
Montagnana, M., Danese, E., & Lippi, G. (2018) · Annals of Translational Medicine · doi:10.21037/atm.2018.07.22 · Cited by 108 · see citing works
Serological markers for human intestinal ischemia: A systematic review
Derikx, J. P. M., Schellekens, D. H. S. M., & Acosta, S. (2017) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2017.01.004 · Cited by 96 · see citing works
Self-citationDiagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far
Peoc’h, K., Nuzzo, A., Guedj, K., Paugam, C., & Corcos, O. (2018) · Clinical Chemistry and Laboratory Medicine (CCLM) · doi:10.1515/cclm-2017-0291 · Cited by 86 · see citing works
Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia
Nuzzo, A., Guedj, K., Curac, S., Hercend, C., Bendavid, C., Gault, N., Tran-Dinh, A., Ronot, M., Nicoletti, A., Bouhnik, Y., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-98012-w · Cited by 67 · see citing works
Reintam Blaser, A., Starkopf, J., Björck, M., Forbes, A., Kase, K., Kiisk, E., Laisaar, K.-T., Mihnovits, V., Murruste, M., Mändul, M., et al. (2023) · World Journal of Emergency Surgery · doi:10.1186/s13017-023-00512-9 · Cited by 67 · see citing works
“[75].”
Bourcier, S., Klug, J., & Nguyen, L. S. (2021) · World Journal of Gastroenterology · doi:10.3748/wjg.v27.i26.4088 · Cited by 65 · see citing works
Plasma biomarkers for early diagnosis of acute intestinal ischemia
Powell, A., & Armstrong, P. (2014) · Seminars in Vascular Surgery · doi:10.1053/j.semvascsurg.2015.01.008 · Cited by 60 · see citing works
Carver, T. W., Vora, R. S., & Taneja, A. (2016) · Critical Care Clinics · doi:10.1016/j.ccc.2015.11.001 · Cited by 58 · see citing works
Urine intestinal fatty acid-binding protein predicts acute mesenteric ischemia in patients
Salim, S. Y., Young, P. Y., Churchill, T. A., & Khadaroo, R. G. (2017) · Journal of Surgical Research · doi:10.1016/j.jss.2016.07.017 · Cited by 48 · see citing works
Bourcier, S., Ulmann, G., Jamme, M., Savary, G., Paul, M., Benghanem, S., Lavillegrand, J.-R., Schmidt, M., Luyt, C.-E., Maury, E., et al. (2022) · Annals of Intensive Care · doi:10.1186/s13613-022-01092-8 · Cited by 37 · see citing works
Nonocclusive mesenteric infarction after cardiac surgery: potential biomarkers
Hong, J., Gilder, E., Blenkiron, C., Jiang, Y., Evennett, N. J., Petrov, M. S., Phillips, A. R. J., Windsor, J. A., & Gillham, M. (2017) · Journal of Surgical Research · doi:10.1016/j.jss.2016.12.001 · Cited by 27 · see citing works
Rittgerodt, N., Pape, T., Busch, M., Becker, L. S., Schneider, A., Wedemeyer, H., Seeliger, B., Schmidt, J., Hunkemöller, A. M., Fuge, J., et al. (2022) · Critical Care · doi:10.1186/s13054-022-03962-w · Cited by 26 · see citing works
Harki, J., Vergouwe, Y., Spoor, J. A., Mensink, P. B., Bruno, M. J., van Noord, D., Kuipers, E. J., & Tjwa, E. T. T. L. (2017) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000000605 · Cited by 23 · see citing works
Krychtiuk, K. A., Richter, B., Lenz, M., Hohensinner, P. J., Huber, K., Hengstenberg, C., Wojta, J., Heinz, G., & Speidl, W. S. (2020) · Resuscitation · doi:10.1016/j.resuscitation.2020.05.046 · Cited by 17 · see citing works
Clinical Presentation, Etiology, and Diagnostic Considerations
David, R. A., Erben, Y., & Kalra, M. (2015) · Mesenteric Vascular Disease · doi:10.1007/978-1-4939-1847-8_15 · Cited by 6 · see citing works
- Authors
- Thuijls, G., Wijck, K. V., Grootjans, J., Derikx, J. P. M., van Bijnen, A. A., Heineman, E., Dejong, C. H. C., Buurman, W. A., & Poeze, M.
- Affiliations
- Maastricht University Medical Centre (NL)
- Venue
- Annals of Surgery
- Published
- 2011-02
- Volume
- 253
- Issue
- 2
- Pages
- 303-308
- ISSN
- 0003-4932 (ISSN-L)
- OpenAlex
- W2013803020
- Cited by
- 217
- References
- 22
- Citations by year
- 2026: 14 · 2025: 14 · 2024: 18 · 2023: 11 · 2022: 10 · 2021: 20 · 2020: 16 · 2019: 10 · 2018: 7 · 2017: 16 · 2016: 23 · 2015: 13 · 2014: 19 · 2013: 12 · 2012: 12
- FWCI
- 8.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Epidemiology › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- intestinal ischemia, fatty acid binding protein, intestinal fatty acid binding protein, liver fatty acid binding protein, ileal bile acid binding protein, urinary biomarkers, plasma biomarkers, early diagnosis, likelihood ratios
- MeSH terms
- Acute Disease, Adolescent, Adult, Aged, Aged, 80 and over, Child, Female, Gastrointestinal Hormones, Humans, Intestines, Ischemia, Male, Middle Aged, Sensitivity and Specificity, Biomarkers, Early Diagnosis, Fatty Acid-Binding Proteins, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
