Fragkos, KC;
Forbes, A;
(2018)
Citrulline as a marker of intestinal function and absorption in clinical settings: A systematic review and meta-analysis.
United European Gastroenterology Journal
, 6
(2)
pp. 181-191.
10.1177/2050640617737632.
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Abstract
Background: Citrulline has been described as a marker of intestinal function or absorption but evidence varies according to clinical settings. Objective: The objective of this article is to examine the evidence of plasma citrulline as a marker of intestinal function and absorption in various clinical settings. Methods: Studies were examined for p values, means and standard deviations, correlation coefficients or other metrics depicting the association of citrulline with intestinal function. A random effects model was used to produce a pooled estimate. A hierarchical summary receiver operating curve model was fitted for diagnostic accuracy measures. Results: Citrulline levels are correlated strongly with small bowel length in short bowel syndrome patients (r = 0.67). Citrulline is strongly negatively correlated (r = –0.56) with intestinal disease severity with regards to enteropathies (coeliac disease, tropical enteropathy, Crohn’s disease, mucositis, acute rejection in intestinal transplantation). Citrulline cut-off levels have an overall sensitivity and specificity of 80% and 84% respectively. Citrulline levels in untreated coeliac patients compared to controls were reduced by 10 µmol/l. Citrulline levels increase with gluten-free diet and with improvement of enteropathy. Citrulline is decreased in critical illness and sepsis. Conclusion: These findings allow us to advocate quite reasonably that citrulline is a marker of acute and chronic intestinal insufficiency.
| Type: | Article |
|---|---|
| Title: | Citrulline as a marker of intestinal function and absorption in clinical settings: A systematic review and meta-analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/2050640617737632 |
| Publisher version: | https://doi.org/10.1177/2050640617737632 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Gastroenterology & Hepatology, Citrulline, meta-analysis, short bowel syndrome, enteropathy, systematic review, SHORT-BOWEL SYNDROME, PLASMA CITRULLINE, SERUM CITRULLINE, ACUTE REJECTION, NECROTIZING ENTEROCOLITIS, TRANSPLANT RECIPIENTS, MYELOABLATIVE THERAPY, DIAGNOSTIC-ACCURACY, ENTEROCYTE MASS, VILLOUS ATROPHY |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10129712 |
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