Faecal calprotectin: factors affecting levels and its potential role as a surrogate marker for risk of development of Crohn’s Disease

Abstract

BackgroundFaecal calprotectin (FC) is one of the most widely used non-invasive tests for the diagnosis and assessment of Crohn’s disease (CD) activity. Despite this, factors other than disease activity which affect levels have not been extensively reviewed. This is of importance when using FC in the diagnostic setting but also may be of utility in studying the aetiology of disease.ObjectivesOur review outlines environmental risk factors that affect FC levels influencing diagnostic accuracy and how these may be associated with risk of developing CD. FC as a surrogate marker could be used to validate risk factors established in case control studies where prospective studies are not feasible. Proof of this concept is provided by our identification of obesity as being associated with elevated FC, our subsequent confirmation of obesity as risk factor for CD and the subsequent verification in prospective studies, as well as associations of lack of physical activity and dietary fibre intake with elevated FC levels and their subsequent confirmation as risk factors in prospective studies.ConclusionWe believe that FC is likely to prove a useful surrogate marker for risk of developing CD. This review has given a theoretical basis for considering the epidemiological determinants of CD which to date has been missing.

A Study of Fecal Calprotectin in Obese Children and Adults

“…Our results in adult groups are consistent with the reports by Mendall et al12 In a middle-aged healthy general population sample of 300 subjects (range, 50–70 years), they reported that the relationship of FC with BMI was not statistically significant, but the mean of FC in obese and overweight adult (BMI, 25.7–41.2 kg/m 2 ) was higher than that in non-obese and overweight (BMI, 17.6–25.6 kg/m 2 ) 16. What does it suggest that there is statistically not significant but difference between obese and overweight and non-obese and overweight groups?…”

“…Diagnosis was based on the World Health Organization criteria in Asians as those with a BMI ≥23 and ≥25 kg/m 2 for overweight and obese adult10 and criteria of Korea Centers for Disease Control Prevention as those with BMI ≥85th and ≥95th percentiles for overweight and obese children 11. The subjects in the study met the exclusion criteria, based on a study of factors affecting levels of FC12, which are as follows: no history of colorectal or systemic inflammatory condition, proton pump inhibitor use, regular (≥4 doses per week) use of nonsteroidal anti-inflammatory drugs, smoking or alcohol. The study was approved by the Ethical Committee of Cheju Halla General Hospital (No.…”

Efficacy of an Anthocyanin and Prebiotic Blend on Intestinal Environment in Obese Male and Female Subjects

“…The levels of fecal calprotectin at the beginning of the study were not as high as previous levels found in other obese subject populations [ 37 – 39 ]. Although fecal calprotectin is a test that is commonly used in research, little work has been done to determine normal levels in different populations [ 40 ].…”

The role of fecal calprotectin in pediatric disease

“…High FC levels were reported in individuals with increased body mass index (>25 kg/m 2 ). The diminished levels of Paneth cell, which plays a key role in the maintenance of the GI barrier, observed in obese subjects may partly explain the local intestinal inflammation [18,19]. Dietary supplements such as zinc, vitamin D, and several probiotics can affect FC levels [18].…”

“…The diminished levels of Paneth cell, which plays a key role in the maintenance of the GI barrier, observed in obese subjects may partly explain the local intestinal inflammation [18,19]. Dietary supplements such as zinc, vitamin D, and several probiotics can affect FC levels [18]. Also, the use of nonsteroidal anti-inflammatory drugs and proton pump inhibitors have been associated with FC elevation [20].…”