The Intestinal Fatty Acid Binding Protein Diagnosing Gut Dysfunction in Acute Pancreatitis A Pilot Study

Objectives: To study the use of intestinal fatty acid binding protein (I-FABP) in diagnosing gut dysfunction in patients with acute pancreatitis (AP). Methods: Thirty-two patients with AP onset within 7 days were enrolled in our study. The severity of disease and the gut dysfunction were evaluated as follows: on admission, on the seventh day of disease attack, and on the third day after enteral nutrition. Serum levels of I-FABP, citrulline, and C-reactive protein (CRP) and the lactulose and mannitol absorption ratio in urine were measured in parallel. Results: The serum level of I-FABP increased on admission, and it was more pronounced in severe attacks. All patients had increased gut dysfunction score, serum level of CRP, and urine level of lactulose and mannitol absorption ratio with decreased serum level of citrulline. A positive correlation was found between the following pairs of measurement on admission: serum level of I-FABP and gut dysfunction score, serum level of I-FABP and Acute Physiology and Chronic Health Evaluation II score, I-FABP and serum level of CRP, and serum level of I-FABP and the length of ICU stay. A reverse correlation between the serum level of I-FABP and the serum level of citrulline was found. Conclusions: The serum level of I-FABP can be used for assessing the gut dysfunction and disease severity of AP.