Diagnostic Value of Signal Peptide-CUB-EGF Domain-Containing Protein 1 (SCUBE-1), Intestinal Fatty Acid Binding Protein (iFABP), and Ischemia-Modified Albumin (IMA) in Mechanical Bowel Obstruction

Year 2025, Volume: 11 Issue: 4, 370 - 382, 30.11.2025

Ali Aygun , Serpil Yaylaci , Mehmet Seyfettin Sarıbaş , Tevfik Noyan , Kerem Dost Bilmez , Süha Türkmen , Aysel Özpınar

https://doi.org/10.19127/mbsjohs.1764647

Abstract

Objective: Mechanical bowel obstruction (MBO) is a common surgical pathology among patients presenting to the emergency department with abdominal pain worldwide and is associated with high morbidity rates. Delays in diagnosis and surgical intervention decisions can lead to severe complications such as bowel ischemia, adversely affecting patient survival rates. Therefore, reliable biomarkers are needed for the early diagnosis of MBO and in the surgical decision-making process. This study aimed to evaluate the diagnostic value of i-FABP, SCUBE-1, and IMA in predicting strangulation and bowel ischemia.
Method: This prospective study was conducted at a tertiary hospital between January 2020 and January 2022. The study included 44 patients diagnosed with mechanical bowel obstruction who presented to the emergency department with abdominal pain, along with a control group of 40 healthy individuals. Patients were classified into two groups based on the need for surgical intervention: those who underwent surgery (Group B) and those who did not (Group A). Venous blood samples were collected, and the levels of i-FABP, SCUBE-1, and IMA were measured using the ELISA method. Data were analyzed using SPSS software.
Results: The mean i-FABP levels were 56.4±11.5 ng/mL in Group A, 62.3±10.1 ng/mL in Group B, and 41.9±12.2 ng/mL in the control group, with a statistically significant difference observed between the groups (p<0.001). SCUBE-1 levels were measured as 80.3±84.9 ng/mL in Group A and 132.4±124.7 ng/mL in Group B, and this difference was found to be statistically significant (p=0.001). The IMA values were 88.8±14.3 ng/mL in Group A, 106.1±29.9 ng/mL in Group B, and 90.1±14.1 ng/mL in the control group, with a significant difference observed between the groups (p<0.001).
Conclusion: This study evaluated the diagnostic value of SCUBE-1, i-FABP, and IMA biomarkers in patients diagnosed with MBO and demonstrated that these biomarkers could serve as important tools in determining the need for surgical intervention. SCUBE-1, i-FABP, and IMA levels were found to show a significant difference in predicting bowel ischemia and strangulation.

Keywords

Bowel obstruction , iFABP , IMA , Ischemia , SCUBE 1

Ethical Statement

This study was approved by the Acıbadem Mehmet Ali Aydınlar University Medical Research Ethics Committee (decision number 2019-9/15)

Thanks

None.

References

• Cha YS, Lee KH, Lee JW, Choi EH, Kim HI, Kim OH, et al. The use of delta neutrophil index and myeloperoxidase index as diagnostic predictors of strangulated mechanical bowel obstruction in the emergency department. Medicine (Baltimore). 2016;95(48):e5481.
• Pujahari AK. Decision Making in Bowel Obstruction: A Review. J Clin Diagn Res. 2016 Nov;10(11):07-12.
• Karakaş DÖ, Yeşiltaş M, Gökçek B, Eğin S, Hot S. Etiology, Management, and Survival of Acute Mechanical Bowel Obstruction: Five-Year Results of A Training and Research Hospital in Turkey. Turkish J Trauma Emerg Surg. 2019;25(3):268-280.
• Cekic AB, Gonenc CO, Aygun A, Pasli S, Yaman OS, Caner KS et al. The Diagnostic Value of ischemia-modified albumin (IMA) and signal peptide-CUB-EGF domain-containing protein-1 (SCUBE-1) in an Experimental Model of Strangulated Mechanical Bowel Obstruction. J Investig Surg. 2022;35(2):450-456.
• Lee H, Kim IK, Ju MK. Which patients with intestinal obstruction need surgery? The delta neutrophil index as an early predictive marker. Ann Surg Treat Res. 2017;93(5):272.
• Payza U, Kayali A, Bilgin S, Karakaya Z, Esad Topal F. When is the right time to take an emergency surgery decision in Mechanical Intestinal Obstruction? Asian J Surg. 2021;44(6):854-859.
• Friziero A, Rosso E, Zuin IS, Vallese L, Serafini S, Amico A, et al. Neutrophil to lymphocyte ratio predicts bowel ischemia in non-strangulated adhesive small bowel occlusions: a retrospective analysis from an acute care surgical service. BMC Surg. 2024;24(1):179.
• Eren T, Boluk S, Bayraktar B, Ozemir IA, Yildirim BS, Tombalak E et al. Surgical indicators for the operative treatment of acute mechanical intestinal obstruction due to adhesions. Ann Surg Treat Res. 2015;88(6):325-333.
• Sun DL, Cen YY, Li SM, Li WM, Lu QP, Xu PY. Accuracy of the serum intestinal fatty-acid-binding protein for diagnosis of acute intestinal ischemia: a meta-analysis. Sci Rep. 2016;6(1):34371.
• Yoon JB, Lee SH. The neutrophil-to-lymphocyte ratio has feasible predictive value for hospital mortality in patients with small bowel obstruction in the emergency department. Am J Emerg Med. 2021;44:428-433.
• Nuzzo A, Guedj K, Curac S, Hercend C, Bendavid C, Gault N, et al. Accuracy of citrulline, I-FABP and d-lactate in the diagnosis of acute mesenteric ischemia. Sci Rep. 2021;11(1):18929.
• Shi H, Wu B, Wan J, Liu W, Su B. The role of serum intestinal fatty acid binding protein levels and D-lactate levels in the diagnosis of acute intestinal ischemia. Clin Res Hepatol Gastroenterol. 2015;39(3):373-378.
• Tyagunov AE, Anurov MV, Titkova SM, Kurashinova LS, Loban KM, Tyagunov AA, et al. Intestinal fatty acid-binding protein (I-FABP) as biomarker of ischemic damage in experimentally induced 12-h small bowel obstruction. Updates Surg. 2024;76(7):2693-2700.
• Fedai H, Toprak K, Cetin M, Elmas AN, Tosun V, Demirbag R. The assessment of the relationship between the development of cardiovascular diseases and SCUBE-1 level in individuals exposed to loud noise. Medicine (Baltimore). 2024;103(51):e41053.
• Xiao L, Wang M, Yang S, Li S, Huang Q, Xu L, et al. The diagnostic potential of plasma SCUBE-1 concentration for pulmonary embolism: A pilot study. Clin Respir J. 2023;17(4):263-269.
• Kaplan M, Yuksel M, Ates I, Kilic ZM, Kilic H, Kuzu UB, et al. Is ischemia modified albumin a disease activity marker for inflammatory bowel diseases? J Gastroenterol Hepatol. 2016;31(6):1120-1125.
• Yeniocak S, Saraç F, Yazıcıoğlu M, Karabulut N, Unal A, Yücetaş E, et al. The Diagnostic Values of Ischemia-Modified Albumin in Patients with Acute Abdominal Pain and Its Role in Differentiating Acute Abdomen. Emerg Med Int. 2020;2020:1-7.
• Kittaka H, Akimoto H, Takeshita H, Funaoka H, Hazui H, Okamoto M, et al. Usefulness of intestinal fatty acid-binding protein in predicting strangulated small bowel obstruction. PLoS One. 2014;9(6):e99915.
• Kanda T, Tsukahara A, Ueki K, Sakai Y, Tani T, Nishimura A, et al. Diagnosis of ischemic small bowel disease by measurement of serum intestinal fatty acid-binding protein in patients with acute abdomen: a multicenter, observer-blinded validation study. J Gastroenterol. 2011;46(4):492-500.
• Aköz A, Türkdoğan KA, Kahraman CN, Kum S, Duman A, Türe M, et al. Predicting Critical Duration and Reversibility of Damage in Acute Mesenteric Ischemia: an experimental study. Turkish J Trauma Emerg Surg. 2018;24(6):507-513.
• Bolayır HA, Gunes H, Kıvrak T, Sahin O, Akaslan D, Kurt R, et al. The role of SCUBE1 in the pathogenesis of no-reflow phenomenon presenting with ST segment elevation myocardial infarction. Anatol J Cardiol. 2017;18(2):122-127.
• Turkmen S, Mentese S, Mentese A, Sumer AU, Saglam K, Yulug E, et al. The value of signal peptide-CUB-EGF domain-containing protein 1 and oxidative stress parameters in the diagnosis of acute mesenteric ischemia. Acad Emerg Med. 2013 Mar;20(3):257-64.
• Dai DF, Thajeb P, Tu CF, Chiang FT, Chen CH, Yang RB, et al. Plasma Concentration of SCUBE1, a Novel Platelet Protein, Is Elevated in Patients With Acute Coronary Syndrome and Ischemic Stroke. J Am Coll Cardiol. 2008;51(22):2173-2180.
• Shevtsova A, Gordiienko I, Tkachenko V, Ushakova G. Ischemia-Modified Albumin: Origins and Clinical Implications. Dis Markers. 2021;2021:9945424.
• Abboud H, Labreuche J, Meseguer E, Lavallee PC, Simon O, Olivot JM, et al. Ischemia-Modified Albumin in Acute Stroke. Cerebrovasc Dis. 2007;23(2-3):216-220.
• Hazini A, Cemek M, Isıldak İ, Alpdagtas S, Onul A, Senel U, et al. Investigation of ischemia modified albumin, oxidant and antioxidant markers in acute myocardial infarction. Postep w Kardiol interwencyjnej = Adv Interv Cardiol. 2015;11(4):298-303.
• Kaya Z, Kayrak M, Gul EE, Altunbas G, Toker A, Kiyici A, et al. The role of ischemia modified albumin in acute pulmonary embolism. Heart Views. 2014;15(4):106-110.
• Gunduz A, Turedi S, Mentese A, Karahan SC, Hos G, Tatli O, et al. Ischemia-modified albumin in the diagnosis of acute mesenteric ischemia: a preliminary study. Am J Emerg Med. 2008;26(2):202-205.
• Tomandlova M, Novotny T, Staffa R, Smutna J, Krivka T, Kruzliak P, et al. Kinetics of d-lactate and ischemia-modified albumin after abdominal aortic surgery and their ability to predict intestinal ischemia. Clin Biochem. 2023;112:43-47.