Fecal elastase and calprotectin levels in stool in the patients with malnutrition, its effect on mortality and morbidity

ABSTRACT Fecal Elastase and Calprotectin Levels In Stool In The Patients With Malnutrition, Its Effect On Mortality and Morbidity Purpose: In this study, it was aimed to make the Gomez and Waterlow classifications of the patients with malnutrition and categorize them according to the patients' demographical characteristics, to check the fecal calprotectin and fecal elastase levels in the stool samples of the patients and to show its relationship with mortality and morbidity. Material and Method: 144 patients who were staying in the services of Çukurova University Faculty of Medicine Paediatrics Department and outpatients who consulted to Paediatrics Gastroenterology and Hepatology Clinics and 23 healthy children were included in this thesis study. The demographical characteristics and laboratory data of the patients were investigated. The fecal elastase and fecal calprotectin levels of the patients and healthy subjects were assayed and its effect on mortality and morbidity was investigated. Findings: 70 of 144 patients were females (48.6%) and 74 of them were males (51.4%). 44 of the patients were diagnosed with cystic fibrosis (30.6%), 51 of them were diagnosed with primary malnutrition (35.4%), 12 of them were diagnosed with coeliac (8.3%) and 5 of them were diagnosed with inflammatory bowel disease (3.5%). The number of the patients with secondary malnutrition was 32 (22.2%). The patients were grouped according to these diagnoses. The fecal elastase levels of the patients with primary malnutrition were found significantly lower than of the subjects in the control group and no significant relationship was found between the fecal calprotectin levels. In all patient groups, the fecal elastase level was significantly lower than of the subjects in the control group. Result: Malnutrition is still a reason of morbidity and mortality in children and it constitutes nearly half of the deaths of the children especially under five (45%). In our study, a negative relationship was found between the period of the mothers' education and waterlow classification. A significant relationship was found between the duration of breastfeeding and malnutrition. As the duration of our study was short and the number of the patients who died was rather low, it was necessary to follow the study group for longer periods in order to determine the effects of some parameters which we checked on mortality. Significant low fecal elastase levels in malnourished patients compared to the control group might show the necessity of pancreatic enzymes in terms of secondary developed pancreatic insufficiency. Keywords: Cystic Fibrosis, Fecal Calprotectin, Fecal Elastase, Malnutrition.