Summary
Conclusion. Near-infrared spectrometry is a new, rapid, and accurate method for measuring fecal fat that does not require a great deal of chemical knowledge and that can be used by anyone. This method is considered indispensable for the diagnosis of pancreatic steatorrhea and treatment follow-up.
Methods. Fecal fats (GLC method, van de Kamer method), neutral sterols (GLC method), bile acids (GLC method) and short-chain fatty acids (HPLC method) were assayed by the respective conventional methods in 120 subjects, including patients with pancreatic dysfunction, and the results were compared with the those obtained by near-infrared spectrometry. The correlations between fecal fat excretion measured by the GLC method (x) and van de Kamer method (x) and by near-infrared spectrometry (y) were expressed by y=1.10 x-0.16 (r=0.949, P<0.01) and y=0.750x+1.654 (r=0.930, p<0.01), respectively.
Results. The sensitivity and specificity of near-infrared spectrometry for fecal fats were 94.9 and 98.2%, respectively, when compared with the GLC method, and 87.5 and 90.0%, respectively, when compared with the van de Kamer method. In contrast, near-infrared spectrometry was not nearly as accurate as the conventional methods for determining neutral sterols, bile acids, and short-chain fatty acids.
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References
Drummey GD, Benson JA Jr, Jones CM. Microscopic examination of the stool for steatorrhea. N Engl J Med 1961; 264: 85–87.
Pimparker BD, Tulsky KG, Kalser MH, Bockus HL. Correlation of radioactive and chemical fecal fat determinations in various malabsorption syndromes. Am J Med 1961; 30: 927–939.
Phuapradit P. Narang A, Mendonca P, Harris DA, Baum JD. The steatocrit: A simple method for estimating stool fat content in newborn infants. Arch Dis Child 1981; 56: 725–727.
Bowers MA, Lund PK, Mathies JC. A rapid, reliable procedure for the determination of total fecal lipids with observation of the lipids excreted by human subjects in normal and pathological states. Clin Chim Acta 1964; 9: 344–347.
van de Kamer JM, Ten Bokkel, Huinink H, Weyers HA. Rapid method for the determination of fat in feces. J Biol Chem 1949; 177: 347–355.
Lapage G, Roy CC. Improved recovery of fatty acids by gas-liquid chromatography through direct transesterification without prior extraction or purification. J Lipid Res 1984; 25: 1391–1396.
Child P, Albe M, Mec D. Separation and quantitation of fatty acids, sterols, and bile acids in feces by gas chromatography as the butyl ester-acetate derivatives. J Chromatogr 1987; 415: 13–26.
Nakamura T, Kikuchi H, Takebe K, Kudoh K, Terada A, Tandoh Y, Yamada N. Faecal lipid excretion levels in normal Japanese females on an unrestricted diet and a fat-restricted diet measured by simultaneous analysis of faecal lipids. J Int Med Res 1992; 20: 461–466.
Schneider MU, Demling L, Jones SA, Barker PJ, Domschke S, Heptner G, Domschke W. NMR spectrometry—a new method for total stool fat quantification in chronic pancreatitis. Dig Dis Sci 1987; 32: 494–499.
Benini L, Caliari S, Guidi GC, Vaona B, Talamini G, Vantini L, Scuro LA. Near infrared spectrometry for faecal fat measurement: comparison with conventional gravimetric and titrimetric methods. Gut 1989; 30: 1344–1347.
Peuchant E, Salles C, Jensen R. Value of a spectroscopic “fecalogram” in determining the etiology of steatorrhea. Clin Chem 1988; 34: 5–8.
Koumantakis G, Radoliff FJ. Estimating fat in feces by near-infrared reflectance spectroscopy. Clin Chem 1987; 33: 502–506.
Norris KH, Butler WL. Techniques for obtaining absorption spectra on intact biological samples. LRE Trans Bio Med Electron 1961; 8: 153–157.
Nakamura T, Takebe K, Yamada N, Arai Y, Tando Y, Terada A, Ishii M, Kikuchi H, Machida K, Imamura K. Bile acid malabsorption as a cause of hypocholesterolemia seen in patients with chronic pancreatitis. Int J Pancreatol 1994; 16: 165–169.
Vuoristo M, Vaananen H, Miettinen TA. Cholesterol malabsorption in pancreatic insufficiency: effects of enzyme substitution. Gastroenterology 1992; 102: 647–655.
Nakamura T, Kikuchi H, Takebe K, Ishii M, Imamura K, Yamada N, Kudoh K, Terada A. Correlation between bile acid malabsorption and pancreatic exocrine dysfunction in patients with chronic pancreatitis. Pancreas 1994; 9: 580–584.
Roller RJ, Kern F Jr. Minimal bile acid malabsorption and normal bile acid breath test in cystic fibrosis and acquired pancreatic insufficiency. Gastroenterology 1977; 72: 661–665.
Dutta SK, Anand K, Gadacz TR. Bile salt malabsorption in pancreatic insufficiency secondary to alcoholic pancreatitis. Gastroenterology 1986; 91: 1243–1249.
Nakamura T, Takebe K, Terada A, Kudoh K, Yamada N, Arai Y, Kikuchi H. Short-chain carboxylic acid in the feces in patients with pancreatic insufficiency. Acta Gastroenterol Belg 1993; 56: 326–331.
Nakamura T, Takebe K, Kudoh K, Ishii M, Imamura K, Kikuchi H, Kasai F, Tando Y, Yamada N, Arai Y, Terada A, Machida K. Steatorrhea in Japanese patients with chronic pancreatitis. J Gastroenterol 1995; 30: 79–83.
Nakamura T, Takeuchi T. Pancreatic steatorrhea, malabsorption, and nutrition biochemistry: a comparison of Japanese, European and American patients with chronic pancreatitis. Pancreas 1997; 14: 323–333.
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Nakamura, T., Takeuchi, T., Terada, A. et al. Near-infrared spectrometry analysis of fat, neutral sterols, bile acids, and short-chain fatty acids in the feces of patients with pancreatic maldigestion and malabsorption. International Journal of Pancreatology 23, 137–143 (1998). https://doi.org/10.1385/IJGC:23:2:137
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DOI: https://doi.org/10.1385/IJGC:23:2:137