I-FABP and LBP as predictive markers for outcomes in surgical patients with multiple organ dysfunction: a prospective observational cohort study

Yermek Meiramovich Turgunov, Alina V. Ogizbayeva, Sofiko Asamidanova, Olga V. Avdienko, D. N. Matyushko, Asset Izdenov, Dinar Kaliyeva, Kayrat T. Shakeyev

2025

Full text Open access: Gold Metadata (CSL-JSON)
DOI 10.21320/1818-474x-2025-4-126-136
Data confidence 70 medium
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Abstract

INTRODUCTION: Multiple organ dysfunction syndrome (MODS) is the most common cause of death in surgical intensive care units. Today intestinal disorders have been highlighted as a driver in the development of MODS. OBJECTIVE: The aim of this study was to evaluate potential biomarkers of bacterial translocation (lipopolysaccharide-binding protein, LBP) and intestinal wall damage (intestinal fatty acid-binding protein, I-FABP) in surgical patients with MODS. MATERIALS AND METHODS: This study involved 165 surgical patients divided into two groups: 118 patients with MODS (main group) and 47 patients without MODS (control group). To identify biomarkers, blood was collected from the control group on the day of admission. In the MODS patients, blood was taken on the first day of MODS, and again on Days 3 and 7 of its development. The markers were determined using the ELISA method. RESULTS: In the control group, the levels of LBP and I-FABP were lower (p < 0.05). In the main group, the mortality rate was 31.4 % (n = 37). The deceased patients had higher I-FABP levels on the first day (p = 0.035), but LBP levels on Day 7 were conversely lower than in the surviving patients (p = 0.016). The threshold values of markers at which the risk of lethal outcome in surgical patients with MODS can potentially increase were calculated using ROC analysis: for LBP on the 7th day, at ≤ 2727.55 ng/mL; and for I-FABP on the 1st day, at > 120.7 pg/mL. CONCLUSIONS: In surgical patients with MODS, increased I-FABP and de-creased LBP may indicate intestinal wall damage and increased bacterial translocation, which may exacerbate the course of MODS. These potential markers can be used to identify MODS patients at higher risk of adverse outcomes.