Plasma D-Lactate Levels In Necrotizing Enterocolitis In Premature Infants

Background: D-Lactate is normally present in the blood of humans at nanomolar concentrations due to methylglyoxal metabolism; millimolar D-lactate concentrations can arise due to excess gastrointestinal microbial production.Objectives: To examine the levels of plasma D-lactate in the necrotizing enterocolitis in premature infants.Patients and Methods: 128 premature infants were divided into control (group I, n = 69), feeding intolerance (group II, n = 42) and NEC (group III, n = 27) groups. Plasma D-lactate levels were measured at the onset of feeding intolerance or NEC and at weeks 2-3 in control infants (group I) by ELISA. Data were analyzed using descriptive statistics, non-parametric tests and Student's t-test.Results: In groups I, II, III, median birth weights were 1845.7 +/- 267.5 g, 1913.1 +/- 306.5 g, and 1898.4 +/- 285.3 g, median gestational ages were 34.3 +/- 1.7 weeks, 33.9 +/- 2.2 weeks and 35.1 +/- 2.6 weeks, ages of sampling were 12.3 +/- 2.9 days, 14.6 +/- 3.7 days and 15.1 +/- 1.8 days, respectively. The differences of median birth weights, median gestational ages and ages of sampling were not statistically significant (P > 0.05). The plasma D-lactate levels in groups I, II, III were 3.6 +/- 1.9 mu g/mL, 12.7 +/- 8.3 mu g/mL, and 35.4 +/- 29.1 mu g/mL, respectively, group III had higher plasma D-lactate level than groups I, II, and the difference among these groups was significant (x(2) = 21.6, P < 0.01).Conclusions: Plasma D-lactate significantly increased early in NEC. Plasma D-lactate levels were associated with extensive disease in NEC infants. Therefore, it could be used as a diagnosis indicator in the early stage of NEC.