Novel biomarkers to determine neonates with necrotizing enterocolitis

Purpose: The diagnosis of Necrotizing Enterocolitis (NEC) is still problematic and finding predictive biomarkers for earlier and better diagnosis is desirable. This retrospective study aimed to investigate the possible correlation between NEC and serum levels of γ-Glutamyltransferase (GGT), serum Total Bilirubin (TBil) and Calcium (Ca2+). Methods: We collected data from 271 neonates of Han nationality (135 NEC cases, 136 non-NEC cases) admitted in the Xi'an Medical School First Affiliated Hospital from 2005 through 2015 who were of term (37-40 w) within 3 d after birth with normal weight (2500-4000 g) and normal serum ALT, AST. Their medical records of serum GGT, TBil, Ca2+ levels from laboratory tests were retrieved and statistically analysed. Results: A significantly higher level of serum GGT , a significantly lower serum TBil and Ca2+ were found in the NEC neonates when compared with those in the control non-NEC group (P<0.001). In single marker analysis, a cut-off point of 2.075 mmol/L of the Ca2+ gave a sensitivity of 81.6% and a specificity of 77.1% to detect NEC whereas combination of our 3 candidate markers (GGT, TBil, Ca2+) gave a sensitivity of 84.4% and a specificity of 87.5% and achieved the biggest area under the curve (0.908) to detect NEC. Conclusion: Our data strongly suggest higher serum GGT levels, together with lower serum TBil and Ca2+ levels may be valuable biomarkers for NEC, and the combination use of the 3 biomarker candidates could be instructive for NEC diagnosis