Plasma citrulline: A marker of enterocyte mass in villous atrophy-associated small bowel disease.

Pascal Crenn 1, * Kouroche Vahedi 1 Anne Lavergne-Slove 2 Luc Cynober 3 Claude Matuchansky 1 Bernard Messing 1
* Auteur correspondant
1 Service d'hépato-gastroentérologie et nutrition
2 Service d'anatomie et cytologie pathologiques
3 Service de biochimie
Abstract : BACKGROUND & AIMS: Plasma citrulline, a nonprotein amino acid produced by enterocytes, was suggested as a marker of remnant enterocyte mass in patients with short bowel. Our objective was to evaluate citrulline as a marker of severity and extent of villous atrophy in patients without intestinal resection. METHODS: Forty-two patients with celiac disease and 10 patients with non-celiac villous atrophy disease were studied by plasma postabsorptive citrulline and biological dosages, biopsies of proximal (duodenojejunal) small bowel and distal ileum (n = 25), or measurement of vitamin B(12) absorption (n = 4). Nine patients were reevaluated after following a gluten-free diet for 1 year. Controls were 51 healthy subjects and 10 severely malnourished patients with anorexia nervosa with no intestinal mucosal abnormalities. RESULTS: Plasma citrulline concentration was lower (P < 0.001) in patients with villous atrophy (24 +/- 13 micromol/L) than in healthy subjects (40 +/- 10 micromol/L) and patients with anorexia nervosa (39 +/- 9 micromol/L). Three thresholds were individualized: <10 micromol/L for patients with diffuse total villous atrophy (n = 10), 10-20 micromol/L for patients with proximal-only total villous atrophy (n = 12), and 20-30 micromol/L for patients with partial villous atrophy (n = 10). Plasma citrulline concentration was correlated to the severity and extent of villous atrophy (r = 0.81; P < 0.001) and to albuminemia (r = 0.47; P < 0.01). Receiver operating characteristic curves indicated that plasma citrulline concentration was the best biological variable to predict villous atrophy. Following a 1-year gluten-free diet, plasma citrulline concentration increased in histologically responsive (n = 6) but not in unresponsive (n = 3) patients. CONCLUSIONS: In patient villous atrophy diseases, plasma citrulline concentration may prove to be a simple and reliable marker of reduced enterocyte mass.
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Gastroenterology, WB Saunders, 2003, 124 (5), pp.1210-9
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  • PUBMED : 12730862

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Pascal Crenn, Kouroche Vahedi, Anne Lavergne-Slove, Luc Cynober, Claude Matuchansky, et al.. Plasma citrulline: A marker of enterocyte mass in villous atrophy-associated small bowel disease.. Gastroenterology, WB Saunders, 2003, 124 (5), pp.1210-9. 〈inserm-00924408〉

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