Fecal calprotectin levels and associated factors in healthy children aged 0-12 months

INTRODUCTION: Fecal calprotectin; is a laboratory examination that has been used in diagnosis and follow-up of diseases with intestinal inflammation, especially inflammatory bowel diseases in older children and adults. The fact that fecal calprotectin is a simple, inexpensive and non-invasive examination has expanded its use in the pediatric age group. In the studies; fecal calprotectin values in healthy infants were shown to be higher than those of older children and adults. But under the age of four; its use is limited due to lack of valid reference values. OBJECTIVE: The aim of this study was to determine the levels of fecal calprotectin and the influencing factors in healthy infants between 0-12 months. METHODS: This descriptive and cross-sectional study was carried out with 84 healthy infants aged 0-12 months who were admitted to Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Child Health Outpatient Clinic. Clinical data and sociodemographic data were recorded in the interviews with the families and with the help of a questionnaire and file reviews. Calprotectin values in the stool were measured by ELISA using the IDK® Calprotectin kit. RESULTS: Fecal calprotectin values of 84 healthy infants between 0-12 months were unevenly distributed and range between 10 and 2078 µg/g. The median value of all participants was 313 µg / g. Fecal calprotectin levels were evaluated by dividing healthy infants into three age groups; the median fecal calprotectin value was 589.5 µg/g in 0-30 days group, 304 µg/g in 31-180 days group and 147.5 µg/g in 181-365 days group. Infants between 0-180 days; the median faecal calprotectin concentration was significantly higher in breast fed infants (median: 499,5 µg/g) than in mixed-fed ones (median: 249 µg/g) (p=0.030). No statistically significant relationship was found between gestational age, probiotic use, iron prophylaxis and rotavirus vaccination and fecal calprotectin. Fecal calprotectin level was found to be significantly higher in infants born by cesarean section compared to spontaneous vaginal delivery in the age group of 31-180 days (p=0.033). Fecal calprotectin values were determined based on 95% percentile; 1581.75 µg/g for the whole group, 1481.15 µg/g for infants between 0-30 days, 1817.3 µg/g for infants between 31-180 days and 802 µg/g for infants between 181-365 days. CONCLUSION: Fecal calprotectin levels in healthy infants between 0-12 months were negatively correlated with age and were higher than those observed in healthy adults and children. Our study showed that high fecal calprotectin levels detected in healthy infants in the first months of life can be affected by age, feeding mode, and mode of delivery.