Abstract：
BACKGROUND: Cross-sectional plasma citrulline concentration (CIT) is considered a marker of enterocyte mass. The role of CIT in clinical practice in patients with short bowel syndrome (SBS) is not clearly defined.
OBJECTIVE: To assess the accuracy of CIT to discriminate SBS from healthy controls (HC) and SBS with intestinal failure (SBS-IF), requiring intravenous supplementation (IVS), from SBS with intestinal insufficiency (SBS-II).
METHODS: Cross-sectional study on unselected outpatients (31 SBS-II, 113 SBS-IF) and 19 healthy controls (HC). Demographic data, SBS characteristics, nutritional status, oral intake, intestinal fat absorption, renal function and IF severity, categorized by the volume of the required IVS, were collected at time of CIT evaluation (µmol/L). Data as mean±SD.
RESULTS: CIT was 36.6 ± 6.0 in HC, 30.2 ± 14.0 in SBS-II and 18.8 ± 12.3 in SBS-IF (p < 0.001). CIT cutoff was 31 for the diagnosis of SBS (sensitivity 79 %, specificity 89 %), and 14 for the discrimination between SBS-IF and SBS-II (sensitivity 100 %, specificity 51 %). Wide ranges of CIT were observed in all SBS-IF severity categories.
CONCLUSIONS: In unselected SBS patients, CIT was accurate to diagnose SBS, had high sensitivity to diagnose SBS-IF but showed low specificity for SBS-II. In SBS-IF, CIT was not an accurate marker of IF severity.
OBJECTIVE: To assess the accuracy of CIT to discriminate SBS from healthy controls (HC) and SBS with intestinal failure (SBS-IF), requiring intravenous supplementation (IVS), from SBS with intestinal insufficiency (SBS-II).
METHODS: Cross-sectional study on unselected outpatients (31 SBS-II, 113 SBS-IF) and 19 healthy controls (HC). Demographic data, SBS characteristics, nutritional status, oral intake, intestinal fat absorption, renal function and IF severity, categorized by the volume of the required IVS, were collected at time of CIT evaluation (µmol/L). Data as mean±SD.
RESULTS: CIT was 36.6 ± 6.0 in HC, 30.2 ± 14.0 in SBS-II and 18.8 ± 12.3 in SBS-IF (p < 0.001). CIT cutoff was 31 for the diagnosis of SBS (sensitivity 79 %, specificity 89 %), and 14 for the discrimination between SBS-IF and SBS-II (sensitivity 100 %, specificity 51 %). Wide ranges of CIT were observed in all SBS-IF severity categories.
CONCLUSIONS: In unselected SBS patients, CIT was accurate to diagnose SBS, had high sensitivity to diagnose SBS-IF but showed low specificity for SBS-II. In SBS-IF, CIT was not an accurate marker of IF severity.
摘要：
背景：横截面血浆瓜氨酸浓度（CIT）被认为是肠上皮细胞质量的标志。CIT在短肠综合征（SBS）患者临床实践中的作用尚不明确。
目的：评估CIT区分SBS与健康对照（HC）和SBS合并肠衰竭（SBS-IF）的准确性，需要静脉补充（IVS），来自肠功能不全的SBS（SBS-II）。
方法：针对未选择的门诊患者的横断面研究（31SBS-II，113个SBS-IF）和19个健康对照（HC）。人口统计数据,SBS特性,营养状况,口服摄入，肠道脂肪吸收，肾功能和IF严重程度，按所需IVS的体积分类，在CIT评估时收集(μmol/L)。数据为平均值±SD。
结果：HC的CIT为36.6±6.0，SBS-II为30.2±14.0，SBS-IF为18.8±12.3（p<0.001）。诊断SBS的CIT临界值为31（敏感性为79%，特异性89%)，14对SBS-IF和SBS-II的区分(灵敏度100%，特异性51%)。在所有SBS-IF严重程度类别中均观察到宽范围的CIT。
结论：在未选择的SBS患者中，CIT对SBS的诊断是准确的，对SBS-IF的诊断敏感性较高，但对SBS-II的特异性较低。在SBS-IF中,CIT不是IF严重程度的准确标记。
目的：评估CIT区分SBS与健康对照（HC）和SBS合并肠衰竭（SBS-IF）的准确性，需要静脉补充（IVS），来自肠功能不全的SBS（SBS-II）。
方法：针对未选择的门诊患者的横断面研究（31SBS-II，113个SBS-IF）和19个健康对照（HC）。人口统计数据,SBS特性,营养状况,口服摄入，肠道脂肪吸收，肾功能和IF严重程度，按所需IVS的体积分类，在CIT评估时收集(μmol/L)。数据为平均值±SD。
结果：HC的CIT为36.6±6.0，SBS-II为30.2±14.0，SBS-IF为18.8±12.3（p<0.001）。诊断SBS的CIT临界值为31（敏感性为79%，特异性89%)，14对SBS-IF和SBS-II的区分(灵敏度100%，特异性51%)。在所有SBS-IF严重程度类别中均观察到宽范围的CIT。
结论：在未选择的SBS患者中，CIT对SBS的诊断是准确的，对SBS-IF的诊断敏感性较高，但对SBS-II的特异性较低。在SBS-IF中,CIT不是IF严重程度的准确标记。
