Fecal calprotectin and its association with functional dyspepsia in children

Background Calprotectin is a calcium-binding protein found normally in small amounts within the digestive tract. Fecal calprotectin measurement is used as a biomarker to identify digestive tract inflammation. Functional dyspepsia is one of the most common health issues in children, occurring in 3-27%, and accounts for considerable quality of life impairment and health care expenses. Objective To determine fecal calprotectin concentration in generally healthy children as well as to assess for a possible association between fecal calprotectin and functional dyspepsia. Methods This cross-sectional study was conducted from February to April 2019 in primary school-aged children in Manado, North Sulawesi. Subjects consisted of 38 children aged 6-12 years. Fecal calprotectin was measured in subjects' stool specimens, and considered to be normal if fecal calprotectin concentration of < 50 mu g/g. Diagnosis of functional dyspepsia was defined using the parent-filled Rome IV questionnaire form. Data were analyzed with Chi-square and Phi-coefficient correlation tests. Results Thirty-eight subjects, 22 boys and 16 girls, were grouped according to fecal calprotectin concentration (normal vs. elevated) and functional dyspepsia diagnosis. Mean fecal calprotectin concentration was 312.45 mu g/g in the functional dyspepsia group and 20.89 mu g/g in the healthy group. Elevated fecal calprotectin was found in 55.6% of the functional dyspepsia group and 10.3% of the healthy group. There was a positive correlation between fecal calprotectin elevation and functional dyspepsia (r=0.471; P=0.004). Conclusion Current fecal calprotectin physiological cut-off level of 50 mu g/g seems valid for children aged 6-12 years. Elevated fecal calprotectin is associated with functional dyspepsia in children.