Journal article
Acylcarnitine Profiles Reflect Metabolic Vulnerability for Necrotizing Enterocolitis in Newborns Born Premature
The Journal of pediatrics, Vol.181, pp.80-85.e1
02/2017
DOI: 10.1016/j.jpeds.2016.10.019
PMCID: PMC5538349
PMID: 27836286
Abstract
To evaluate the association between newborn acylcarnitine profiles and the subsequent development of necrotizing enterocolitis (NEC) with the use of routinely collected newborn screening data in infants born preterm.
A retrospective cohort study was conducted with the use of discharge records for infants born preterm admitted to neonatal intensive care units in California from 2005 to 2009 who had linked state newborn screening results. A model-development cohort of 94 110 preterm births from 2005 to 2008 was used to develop a risk-stratification model that was then applied to a validation cohort of 22 992 births from 2009.
Fourteen acylcarnitine levels and acylcarnitine ratios were associated with increased risk of developing NEC. Each log unit increase in C5 and free carnitine /(C16 + 18:1) was associated with a 78% and a 76% increased risk for developing NEC, respectively (OR 1.78, 95% CI 1.53-2.02, and OR 1.76, 95% CI 1.51-2.06). Six acylcarnitine levels, along with birth weight and total parenteral nutrition, identified 89.8% of newborns with NEC in the model-development cohort (area under the curve 0.898, 95% CI 0.889-0.907) and 90.8% of the newborns with NEC in the validation cohort (area under the curve 0.908, 95% CI 0.901-0.930).
Abnormal fatty acid metabolism was associated with prematurity and the development of NEC. Metabolic profiling through newborn screening may serve as an objective biologic surrogate of risk for the development of disease and thus facilitate disease-prevention strategies.
Details
- Title: Subtitle
- Acylcarnitine Profiles Reflect Metabolic Vulnerability for Necrotizing Enterocolitis in Newborns Born Premature
- Creators
- Karl G Sylvester - Department of Surgery, Stanford University School of Medicine, Stanford, CAZachary J Kastenberg - Department of Surgery, Stanford University School of Medicine, Stanford, CAR. Larry Moss - Pediatric Surgery, Nationwide Children's Hospital, Ohio State University School of Medicine, Columbus, OHGregory M Enns - Department of Pediatrics, Stanford University School of Medicine, Stanford, CATina M Cowan - Department of Pathology, Stanford University School of Medicine, Stanford, CAGary M Shaw - Department of Pediatrics, Stanford University School of Medicine, Stanford, CADavid K Stevenson - Department of Pediatrics, Stanford University School of Medicine, Stanford, CATiffany J Sinclair - Department of Surgery, Stanford University School of Medicine, Stanford, CACurt Scharfe - Stanford Genome Technology Center, Stanford University, Palo Alto, CAKelli K Ryckman - Departments of Epidemiology and Pediatrics, College of Public Health and Carver College of Medicine, University of Iowa, Iowa, IALaura L Jelliffe-Pawlowski - Department of Epidemiology and Biostatistics, Division of Preventive Medicine and Public Health, University of California San Francisco School of Medicine, San Francisco, CA
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.181, pp.80-85.e1
- DOI
- 10.1016/j.jpeds.2016.10.019
- PMID
- 27836286
- PMCID
- PMC5538349
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier Inc
- Grant note
- UL1 TR001085 / Stanford Clinical and Translational Science Award MOD PR625253 / Stanford University School of Medicine (http://dx.doi.org/10.13039/100006521) R00HD065786 / Eunice Kennedy Shriver National Institute of Child Health and Human Development (http://dx.doi.org/10.13039/100009633) March of Dimes Foundation (http://dx.doi.org/10.13039/100000912) Stanford Child Health Research Institute HS000028 / Agency for Healthcare Research and Quality (http://dx.doi.org/10.13039/100000133) 1UO1FD004194-01 / US Food and Drug Administration (http://dx.doi.org/10.13039/100000038) UL1 RR025744 / The Jack and Marion Euphrat Fellowship in Pediatric Translational Medicine and Stanford Clinical and Translational Science Award
- Language
- English
- Date published
- 02/2017
- Academic Unit
- Stead Family Department of Pediatrics; Epidemiology
- Record Identifier
- 9983996066902771
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