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http://dx.doi.org/10.5223/pghn.2022.25.1.1

Fecal Calprotectin and Phenotype Severity in Patients with Cystic Fibrosis: A Systematic Review and Meta-Analysis  

Talebi, Saeedeh (Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences)
Day, Andrew S. (Department of Pediatrics, University of Otago (Christchurch))
Rezaiyan, Majid Khadem (Department of Community Medicine, Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences)
Ranjbar, Golnaz (Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences)
Zarei, Mitra (Department of Knowledge and Information Science, Faculty of Medicine, Mashhad University of Medical Sciences)
Safarian, Mahammad (Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences)
Kianifar, Hamid Reza (Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.25, no.1, 2022 , pp. 1-12 More about this Journal
Abstract
Inflammation plays an important role in the outcome of patients with cystic fibrosis (CF). It may develop due to cystic fibrosis transmembrane conductance regulator protein dysfunction, pancreatic insufficiency, or prolonged pulmonary infection. Fecal calprotectin (FC) has been used as a noninvasive method to detect inflammation. Therefore, the aim of the current meta-analysis was to investigate the relationship between FC and phenotype severity in patients with CF. In this study, searches were conducted in PubMed, Science Direct, Scopus, and Embase databases up to August 2021 using terms such as "cystic fibrosis," "intestine," "calprotectin," and "inflammation." Only articles published in English and human studies were selected. The primary outcome was the level of FC in patients with CF. The secondary outcome was the relationship between FC and clinical severity. Statistical analysis was performed using Comprehensive Meta-Analysis software. Of the initial 303 references, only six articles met the inclusion criteria. The mean (95% confidence interval [CI]) level of FC was 256.5 mg/dL (114.1-398.9). FC levels were significantly associated with pancreatic insufficiency (mean, 243.02; 95% CI, 74.3 to 411.6; p=0.005; I2=0), pulmonary function (r=-0.39; 95% CI, -0.58 to -0.15; p=0.002; I2=60%), body mass index (r=-0.514; 95% CI, 0.26 to 0.69; p<0.001; I2=0%), and Pseudomonas colonization (mean, 174.77; 95% CI, 12.5 to 337.02; p=0.035; I2=71%). While FC is a reliable noninvasive marker for detecting gastrointestinal inflammation, it is also correlated with the severity of the disease in patients with CF.
Keywords
Cystic fibrosis; Calprotectin; Inflammation; Exocrine pancreatic insufficiency;
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