Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia

Early diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI-citrulline, intestinal fatty acid-binding protein (I-FABP), and d-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients-50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 mu mol/L (12.0-26.0) vs. 23.3 mu mol/L (18.3-29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58-0.78). No statistical difference was found in plasma I-FABP and plasma d-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and d-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.

Automated summary

This study aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI, including citrulline, I-FABP, and d-lactate. The results showed that citrulline concentration was significantly lower in AMI patients compared to controls, but it had low accuracy in diagnosing AMI. I-FABP and d-lactate did not show statistical differences between AMI patients and controls, indicating a need for further research to identify new biomarkers.