Poor Diagnostic Accuracy of a Single Fasting Plasma Citrulline Concentration to Assess Intestinal Energy Absorption Capacity

Peters, Job H. C.; Wierdsma, Nicolette J.; Teerlink, Tom; van Leeuwen, Paul A.M.; Mulder, Chris J. J.; Bodegraven, Ad A. van
December 2007
American Journal of Gastroenterology;Dec2007, Vol. 102 Issue 12, p2814
Academic Journal
OBJECTIVES: Our aim was to explore the diagnostic value of fasting citrulline concentrations to detect decreased intestinal energy absorption in patients with recently diagnosed celiac disease (CeD), refractory celiac disease (RCeD), and short bowel syndrome (SBS). Decreased intestinal energy absorption is regarded a marker of intestinal failure. METHODS: Fasting plasma citrulline concentrations were determined by high performance liquid chromatography (HPLC) in a prospective study of 30 consecutive adult patients (15 CeD, 9 RCeD, and 16 SBS) and 21 healthy subjects. Intestinal energy absorption capacity using bomb calorimetry was determined in all patients and healthy subjects and was regarded as the gold standard for intestinal energy absorption function. RESULTS: The mean fasting plasma citrulline concentration was lower in RCeD patients than in healthy subjects (28.5 ± 9.9 vs 38.1 ± 8.0 μmol/L, P < 0.05) and CeD patients (28.5 ± 9.9 vs 38.1 ± 6.4 μmol/L, P < 0.05), however, clearly within reference values. The mean intestinal energy absorption capcity was lower in SBS patients than in healthy subjects (64.3 ± 18.2 vs 90.3 ± 3.5%, P < 0.001), CeD patients (64.3 ± 18.2 vs 89.2 ± 3.4%, P < 0.001), and the RCeD group (64.3 ± 18.2 vs 82.3 ± 11.7%, P < 0.01). No relation was observed between fasting plasma citrulline concentration and intestinal energy absorption capacity (Pearson r= 0.09, P= 0.56). The area under the ROC curve for fasting plasma citrulline to detect decreased intestinal energy absorption capcity ( i.e., < 85%) was 0.50. CONCLUSION: Fasting plasma citrulline concentrations have poor test characteristics for detection of decreased intestinal energy absorption capacity in patients with enterocyte damage.


Related Articles

  • Prevalence of Celiac Disease in Latin America: A Systematic Review and Meta-Regression. Parra-Medina, Rafael; Molano-Gonzalez, Nicolás; Rojas-Villarraga, Adriana; Agmon-Levin, Nancy; Arango, Maria-Teresa; Shoenfeld, Yehuda; Anaya, Juan-Manuel // PLoS ONE;May2015, Vol. 10 Issue 5, p1 

    Background: Celiac disease (CD) is an immune-mediated enteropathy triggered by the ingestion of gluten in susceptible individuals, and its prevalence varies depending on the studied population. Given that information on CD in Latin America is scarce, we aimed to investigate the prevalence of CD...

  • Reflux, IBS rates higher in CD.  // GIG Newsletter;Spring2011, Vol. 34 Issue 2, p43 

    The article reports on the high incidence of reflux and irritable bowel syndrome among patients with celiac disease based on a study published in a 2011 issue of "European Journal of Gastroenterology."

  • Malrotation: some answers but more questions. Slovis, Thomas; Strouse, Peter // Pediatric Radiology;Apr2009, Vol. 39 Issue 4, p315 

    The authors reflect on the continual conundrum about the diagnosis and misdiagnosis of malrotation. Primarily, they analyze the research headed by B. Lampl on the stretchability of the ligament of Treitz, targeting to explain the malposition of the duodenal-jejunal junction in some normal...

  • Coeliac disease with farmers' lung. Robinson, T.J. // British Medical Journal;3/27/1976, Vol. 1 Issue 6012, p745 

    Examines the patients with celiac disease associated with allergic alveolitis. Measurement of hemoglobin levels; Diagnosis of the disease; Management and treatment of the disease.

  • Celiac disease in cryptogenic hypertransaminasemia. Shahbazkhani, Bijan; Mehrabi, Gholamali; Nasiritosi, Mohsen; Forotan, Hosein; Asefirad, Shadi // Tehran University Medical Journal;Oct2010, Vol. 68 Issue 7, p428 

    Background: In the patients with chronic liver disease chronic increase in serum transaminases may remain of undetermined cause despite thorough investigations. Celiac disease (non tropical sprue) has been reported as one of the causes of elevated levels of serum transaminases. The aim of this...

  • IgA antibodies of coeliac disease patients recongnise a dominant T cell epitope of A-gliadin. Bateman, E. A. L.; Ferry, B. L.; Hall, A.; Misbah, S. A.; Anderson, R.; Kelleher, P. // Gut;Sep2004, Vol. 53 Issue 9, p1274 

    Background: In coeliac disease (CD) patients, the dominant DQ2-A-I-gliadin peptide recognized by CD4 T cells is contained within peptide sequence 57-73 (p57-73) of A-gliadin. This peptide sequence is also located within a 33-mer protease resistant gliadin fragment and therefore is likely to play...

  • Correction: Essential Amino Acids in the Gluten-Free Diet and Serum in Relation to Depression in Patients with Celiac Disease. van Hees, Nathalie J. M.; Giltay, Erik J.; Tielemans, Susanne M. A. J.; Geleijnse, Johanna M.; Puvill, Thomas; Janssen, Nadine; Does, Willem van der // PLoS ONE;Jun2015, Vol. 10 Issue 6, p1 

    No abstract available.

  • Essential Amino Acids in the Gluten-Free Diet and Serum in Relation to Depression in Patients with Celiac Disease. van Hees, Nathalie J. M.; Giltay, Erik J.; Tielemans, Susanne M. A. J.; Geleijnse, Johanna M.; Puvill, Thomas; Janssen, Nadine; Does, Willem van der // PLoS ONE;Apr2015, Vol. 10 Issue 4, p1 

    Introduction: Celiac disease (CD) is associated with an increased risk of major depressive disorder, possibly due to deficiencies in micronutrients in the gluten-free diet. We aimed to investigate whether essential amino acids (i.e., the precursors of serotonin, dopamine and other...

  • A more accurate endoscopy.  // GIG Newsletter;Fall2008, Vol. 31 Issue 4, p30 

    The article discusses research on the use of endoscopy with water immersion technique to find marked villous atrophy (MVA), with reference to a study published in the September 22, 2008 issue of the "Journal of Gastroenterology." Endoscopic results identified 28 patients with MVA who were also...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics