Korean J Pediatr.  2019 Aug;62(8):307-311. 10.3345/kjp.2018.07108.

The relation between serum levels of epidermal growth factor and necrotizing enterocolitis in preterm neonates

• Ahmed HM
• Kamel NM

• KMID: 2456191
• DOI: http://doi.org/10.3345/kjp.2018.07108

Abstract

PURPOSE
Necrotizing enterocolitis (NEC) is one of the most serious complications of prematurity. Many risk factors can contribute to the development of NEC. The epidermal growth factor (EGF) plays a major role in intestinal barrier function, increases intestinal enzyme activity, and improves nutrient transport. The aim of this study was to assess the role of epidermal growth factor in the development of NEC in preterm neonates.
METHODS
In this study, 130 preterm neonates were included and divided into 3 groups, as follows: group 1, 40 preterm neonates with NEC; group 2, 50 preterm neonates with sepsis; and group 3, 40 healthy preterm neonates as controls. The NEC group was then subdivided into medical and surgical NEC subgroups. The serum EGF level was measured using enzyme-linked immunosorbent assay.
RESULTS
Serum EGF levels (pg/dL) were significantly lower in the NEC group (median [interquartile range, IQR], 9.6 [2-14]) than in the sepsis (10.1 [8-14]) and control groups (11.2 [8-14], P<0.001), with no significant difference between the sepsis and control groups, and were positively correlated with gestational age (r=0.7, P<0.001). A binary logistic regression test revealed that low EGF levels and gestational ages could significantly predict the development of NEC. The receiver-operating characteristic curve for EGF showed an optimal cutoff value of 8 pg/mL, with 73.3% sensitivity, 98% specificity, and an area under the curve of 0.92.
CONCLUSION
The patients with NEC in this study had significantly lower serum EGF levels (P<0.001), which indicated that EGF could be a reliable marker of NEC in preterm neonates.

Keyword

Epidermal growth factor; Neonates; Necrotizing enterocolitis

MeSH Terms

Enterocolitis, Necrotizing*
Enzyme-Linked Immunosorbent Assay
Epidermal Growth Factor*
Gestational Age
Humans
Infant, Newborn*
Logistic Models
Risk Factors
Sensitivity and Specificity
Sepsis
Epidermal Growth Factor