Elevated Coefficient of Variation in Total Fecal Bile Acids Precedes Diagnosis of Necrotizing Enterocolitis

Shannon Knapp, Allysa Kehring, Jennifer Stepp, Christine M. Calton, Sheila M. Gephart, Sruti Bandlamuri, Kate E. Boyle, Grey I. Dietz, Haeley Johnson, Ryan E. Romo, Mackenzie Spencer, Alan D. Bedrick, Melissa D. Halpern

Research output: Contribution to journalArticle

Abstract

Accumulation of bile acids (BAs) may mediate development of necrotizing enterocolitis (NEC). Serial fecal samples were collected from premature infants with birth weight (BW) ≤ 1800 g, estimated gestational age (EGA) ≤ 32 weeks, and <30 days old prior to initiation of enteral feeding. Nine infants that developed Bell’s Stage ≥ II NEC were matched with control infants based on BW, EGA, day of life (DOL) enteral feeding was initiated and DOL of the first sample. From each subject, five samples matched by DOL collected were analyzed for BA levels and composition. Fifteen individual BA species were measured via LC-MS/MS and total BA levels were measured using the Diazyme Total Bile Acid Assay kit. No statistically significant differences in composition were observed between control and NEC at the level of individual species (p = 0.1133) or grouped BAs (p = 0.0742). However, there was a statistically significant difference (p = 0.000012) in the mean coefficient of variation (CV) between the two groups with infants developing NEC having more than four-fold higher mean CV than controls. Importantly, these variations occurred prior to NEC diagnosis. These data suggest fluctuations in total fecal BA levels could provide the basis for the first predictive clinical test for NEC.

Original languageEnglish (US)
Article number249
JournalScientific reports
Volume10
Issue number1
DOIs
StatePublished - Dec 1 2020

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Necrotizing Enterocolitis
Bile Acids and Salts
Enteral Nutrition
Birth Weight
Gestational Age
Premature Infants

ASJC Scopus subject areas

  • General

Cite this

Elevated Coefficient of Variation in Total Fecal Bile Acids Precedes Diagnosis of Necrotizing Enterocolitis. / Knapp, Shannon; Kehring, Allysa; Stepp, Jennifer; Calton, Christine M.; Gephart, Sheila M.; Bandlamuri, Sruti; Boyle, Kate E.; Dietz, Grey I.; Johnson, Haeley; Romo, Ryan E.; Spencer, Mackenzie; Bedrick, Alan D.; Halpern, Melissa D.

In: Scientific reports, Vol. 10, No. 1, 249, 01.12.2020.

Research output: Contribution to journalArticle

Knapp, S, Kehring, A, Stepp, J, Calton, CM, Gephart, SM, Bandlamuri, S, Boyle, KE, Dietz, GI, Johnson, H, Romo, RE, Spencer, M, Bedrick, AD & Halpern, MD 2020, 'Elevated Coefficient of Variation in Total Fecal Bile Acids Precedes Diagnosis of Necrotizing Enterocolitis', Scientific reports, vol. 10, no. 1, 249. https://doi.org/10.1038/s41598-019-57178-0
Knapp, Shannon ; Kehring, Allysa ; Stepp, Jennifer ; Calton, Christine M. ; Gephart, Sheila M. ; Bandlamuri, Sruti ; Boyle, Kate E. ; Dietz, Grey I. ; Johnson, Haeley ; Romo, Ryan E. ; Spencer, Mackenzie ; Bedrick, Alan D. ; Halpern, Melissa D. / Elevated Coefficient of Variation in Total Fecal Bile Acids Precedes Diagnosis of Necrotizing Enterocolitis. In: Scientific reports. 2020 ; Vol. 10, No. 1.
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