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 μg/ml, 12.7 ± 8.3 μg/ml, and 35.4 ± 29.1 μg/ml, respectively, group iii had higher plasma d-lactate level than groups i, ii, and the difference among these groups was significant (x² = 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.