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건강한 성인의 연령별 분변 칼프로텍틴의 농도

Age-Related Fecal Calprotectin Concentrations in Healthy Adults

  • 투고 : 2020.08.24
  • 심사 : 2020.08.31
  • 발행 : 2020.09.30

초록

분변 칼프로텍틴(fecal calprotectin, FC)은 염증성 장질환의(inflammatory bowl disease, IBD)의 감별진단을 위한 표지자(marker)로 이용되고 있다. 또한 FC는 세균에 의한 분해가 어려워 실온에서도 1주일 정도 안정적으로 유지되며 대변 내에 균일하게 분포한다는 장점으로 치료효과의 판정과 재발을 에측하는 표지자로 활발히 연구되고 있다. 본 연구는 30~80대까지의 제주 거주 건강한 성인 남녀를 대상으로 하였다. 전체 건강대상군(N=45)의 FC 농도 범위는 0~545.9 ㎍/g로 아주 넓게 분포하였다. 건강한 성인들의 FC농도는 연령에 따라 유의한 차이를 보임을 알 수 있었으며 3개의 연령군 중에서 평균연령이 80.6세인 70세 이상의 연령군의 FC농도는 평균연령이 44세인 50세 미만의 연령군의 FC농도인 15.88 ㎍/g에 비해 약 10배 이상의 농도인 160.3 ㎍/g을 보였고 평균연령이 59.6세의 경우에도 50세 미만 연령층에 비해 2배 이상 농도인 35.46 ㎍/g 보여 연령과 FC 농도 간에는 유의한 상관관계를 보였다. 결론적으로 FC검사가 비침습적이며 비용 효과적이고 객관적인 IBD검사의 marker로 이용되기 위해서는 연령에 따른 정교한 cut-off 값이 필요하며 본 연구 결과가 IBD의 감별진단을 위한 기초자료를 제공할 수 있을 것으로 생각된다.

Fecal calprotectin (FC) is a marker used for the differential diagnosis of inflammatory bowel disease (IBD). FC is also used to determine the effects of treatment and recurrence prediction because of its non-decomposition by bacteria, relative week stability at room temperature, and its uniform distribution within feces. Healthy male and female adults between the age of 30 and 80 living in Jeju were selected for this study. The FC concentration in the healthy control group (N=45) was distributed widely as 0~545.9 ㎍/g and showed a significant difference with age in healthy adults. The FC concentration in adults over 70 years old (80.6 years on average) was 160.3 ㎍/g. The result is approximately 10 times higher than in adults below 50 years (44 years on average), with FC concentrations at 15.88 ㎍/g. Moreover, adults over 50 years, with an average age of 59.6, had FC concentrations of 35.46 ㎍/g, which were two times higher than the below 50-year-old group, confirming the significant correlation between age and FC concentration. As the FC test is a non-invasive and cost-effective objective marker in IBD tests, a suitable cut-off value is required for different ages. This study provides the baseline data for differential diagnoses.

키워드

참고문헌

  1. Molodecky NA, Soon IS, Rabi DM, William A. Ghali WA, Ferris M, et al. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastro. 2012;142:46-54. https://doi.org/10.1053/j.gastro.2011.10.001
  2. Yang SK, Yun SC, Kim JH, Park JY, Kim HY, Kim YH, et al. Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a KASID study. Inflamm Bowel Dis. 2008;14:542-549. https://doi.org/10.1002/ibd.20310
  3. Lee J. Fecal calprotectin in inflammatory bowel disease. Korean J Gastroenterol. 2016;67:233-237. http://doi.org/10.4166/kjg.2016.67.5.233
  4. Stange EF, Travis SP, Vermeire S, Beglinger C, Kupcinskas L, Geboes K, et al. European evidence based consensus on the diagnosis and management of Crohn's disease: definitions and diagnosis. Gut. 2006;55:1-15. https://doi.org/10.1136/gut.2005.081950a
  5. Cobb WS, Heniford BT, Sigmon LB, Hasan R, Simms C, Kercher KW, et al. Colonoscopic perforations: incidence, management, and outcomes. Am Surg. 2004;70:750-757; discussion 757-758.
  6. Sutherland AD, Gearry RB, Frizelle FA. Review of fecal biomarkers in inflammatory bowel disease. Dis Colon Rectum. 2008;51:1283-1291. https://doi.org/10.1007/s10350-008-9310-8
  7. Fagerhol MK, Dale I, Andersson T. A radioimmunoassay for a granulocyte protein as a marker in studies on the turnover of such cells. Bull Eur Physiopathol Respir 1980;16:273-282. https://doi.org/10.1016/B978-0-08-027379-2.50028-4
  8. Roseth A, Fagerhol MK, Aadland E, Schjonsby H. Assessment of the neutrophil dominating protein calprotectin in feces. A methodologic study. Scand J Gastroenterol. 1992;27:793-798. https://doi.org/10.3109/00365529209011186
  9. Vermeire S, Van Assche G, Rutgeerts P. Laboratory markers in IBD: useful, magic, or unnecessary toys? Gut. 2006;55:426-431. https://doi.org/doi:10.1136/gut.2005.069476
  10. Park SH, Kim WJ. A study of fecal calprotectin in obese children and adults. J Obes Metab Syndr. 2018;27:233-237. https://doi.org/10.7570/jomes.2018.27.4.233
  11. Roseth A, Schmidt PN, Fagerhol MK. Correlation between faecal excretion of indium-111-labelled granulocytes and calprotectin, a granulocyte marker protein, in patients with inflammatory bowel disease. Scand J Gastroenterol. 1999;34:50-54. https://doi.org/10.1080/00365529950172835
  12. Lee YW, Lee KM, Lee JM, Chung YY, Kim DB, Kim YJ et al. The usefulness of fecal calprotectin in assessing inflammatory bowel disease activity. Korean J Intern Med. 2019;34:72-80. https://doi.org/10.3904/kjim.2016.324
  13. Olafsdottir E, Aksnes L, Fluge G, Berstad A: Faecal calprotectin levels in infants with infantile colic, healthy infants, children with inflammatory bowel disease, children with recurrent abdominal pain and healthy children. Acta Paediatr. 2002;91:45-50. https://doi.org/10.1080/080352502753457932
  14. Josefsson S, Bunn SK, Domellof M. Fecal calprotectin in very low birth weight infants. J Pediatr Gastroenterol Nutr. 2007;44:407-413. https://doi.org/10.1097/mpg.0b013e3180320643
  15. Yang Q, Smith PB, Goldberg RN, Cotten CM: Dynamic change of fecal calprotectin in very low birth weight infants during the first month of life. Neonatology. 2008;94:267-271. https://doi.org/10.1159%2F000151645 https://doi.org/10.1159/000151645
  16. Yoon JM, Park JY, Ko KO, Lim JW, Cheon EJ, Kim HJ. Fecal calprotectin concentration in neonatal necrotizing enterocolitis. Korean J Pediatr. 2014;57:351-356. http:/doi.org/10.3345/kjp.2014.57.8.351
  17. Van Rheenen PF, Vijver E, Fidler V. Faecal calprotectin for screening of patients with suspected inflammatory bowel disease: diagnostic meta-analysis. BMJ. 2010;341:c3369. https://doi.org/10.1136/bmj.c3369
  18. Kostas A, Siakavellas SI, Kosmidis C, Takou A, Nikou J, Maropoulos G et al. Fecal calprotectin measurement is a marker of shortterm clinical outcome and presence of mucosal healing in patients with inflammatory bowel disease. World Gastroenterol. 2017;23:7387-7396. https://doi.org/10.3748/wjg.v23.i41. 7387
  19. Lee YW, Lee KM, Lee JM, Chung YY, Kim DB, Kim YJ, et al. The usefulness of fecal calprotectin in assessing inflammatory bowel disease activity. Korean J Intern Med. 2019;34;72-80. https://doi.org/10.3904/kjim.2016.324
  20. Yoo IH, Cho JM, Joo JY, Yang H. Fecal calprotectin as a useful non-invasive screening marker for eosinophilic gastrointestinal disorder in Korean children. J Korean Med Sci. 2020;35:e120. https://doi.org/ 10.3346/jkms.2020.35.e120
  21. Gisbert JP, McNicholl AG. Questions and answers on the role of faecal calprotectin as a biological marker in inflammatory bowel disease. Inflamm Bowl Dis. 2009;15:1746-1754. https://doi.org/10.1002/ibd.20920
  22. Seo SC, Ahn SH, Ri SH, Yoon YS, Byeon JH, Kim SH et al. Elevated fecal calprotectin levels are associated with severity of atopic dermatitis in children. Asian Pac J Allergy Immunol. 2018;36:82-87. https://doi.org/10.12932/ap-100317-0044
  23. Mumolo MG, Bertani L, Ceccarelli L, Laino G, Di Fluri G, Albano E, et al. From bench to bedside: fecal calprotectin in inflammatory bowel diseases clinical setting. World J Gastroenterol. 2018;24:3681-3694. http://doi.org/10.3748/wjg.v24.i33.3681
  24. Rogler G, Aldeguer X, Kruis W, Lasson A, Mittmann U, Nally K, et al. Concept for a rapid point-of-care calprotectin diagnostic test for diagnosis and disease activity monitoring in patients with inflammatory bowel disease: expert clinical opinion. J Crohns Colitis. 2013;7:670-677. https://doi.org/10.1016/j.crohns.2013.02.014
  25. Zhu Q, Li F, Wang J, Shen L, Sheng X. Fecal calprotectin in healthy children aged 1-4 years. PLoS One. 2016;11:1-10. https://doi.org/10.1371/journal.pone.0150725
  26. Elin H, James KT, Thorkild T, Lena G, Grace N, Deogratias HKM, et al. Fecal calprotectin concentrations in apparently healthy children aged 0-12 years in urban kampala, Uganda: a community-based survey. BMC Pediatrics. 2011;11;9-16. http://doi.org/10.1186/1471-2431-11-9
  27. Li F, Ma J, Geng S, Wang J, Liu J, Zhang J, et al. Fecal calprotectin concentrations in healthy children aged 1-18 months. PLoS One. 2015;10:e0119574. http://doi.org/10.1371/journal.pone.0119574
  28. Joshi S, Lewis SJ, Creanor S, Ayling RM. Age-related faecal calprotectin, lactoferrin and tumour M2-PK concentrations in healthy volunteers. Ann Clin Biochem. 2010;47:259-263. http://doi.org/10.1258/acb.2009.009061
  29. Leonardil GC, Accardi G, Monastero R, Nicoletti F, Libra M. Ageing: from inflammation to cancer. Immun Ageing. 2018;15:1. https://doi.org/10.1186/s12979-017-0112-5
  30. Poullis A, Foster R. Shetty A, Fagerhol MK, Mendall MA. Bowel inflammation as measured by fecal calprotectin. Cancer Epidemiol Biomarkers Prev. 2004;13;279-284. https://doi.org/10.1158/1055-9965.epi- 03-0160