Nutritional status of patients with biliary atresia and autoimmune hepatitis related to serum levels of vitamins A, D and E

Abstract

-Context -Chronic liver disease may induce to malabsorption of lipids and fat-soluble vitamins, leading to injury of nutritional status. Objectives -To evaluate the nutritional status of pediatric-age patients with autoimmune hepatitis and biliary atresia related to serum levels of vitamins A, D and E and the disease severity. Methods -This controlled transverse study, evaluated the patients with autoimmune hepatitis and biliary atresia and a reference group paired by sex and age. The patients underwent anthropometric evaluation, alimentary inquiry and determination of serum levels of vitamins A, D and E by high performance liquid chromatography. The Mann-Whitney test, Spearman correlation coefficients and variance analysis (ANOVA) were utilized for data treatment, regarding significant difference if P<0.05. Results -The highest nutritional deficit was observed in patients with biliary atresia, mainly with cholestasis. The serum levels of vitamins A and E for the reference group changed as a function of age. The serum levels of vitamins A, D and E were higher in reference group than in patients with biliary atresia and autoimmune hepatitis together or separately. There were not difference in the serum levels of vitamins A, D and E between biliary atresia groups with cholestasis and without cholestasis. It was verified correlation between weight/age, triceps skinfold thickness, subscapular skinfold thickness, midarm circumference, midarm fat area values and vitamin A serum levels, as well as between all anthropometric indicators and vitamin E in patients with autoimmune hepatitis and biliary atresia. Conclusion -The patients with biliary atresia and cholestasis presented the highest nutritional injury. The patients with biliary atresia and autoimmune hepatitis presented lower serum levels of vitamins A, D and E that in control group. There is a directly proportional correlation between vitamin serum levels, mainly vitamin E, and all anthropometric variables of biliary atresia and autoimmune hepatitis groups.

Brain-Derived Neurotrophic Factor in Children and Adolescents with Cirrhosis Due to Biliary Atresia

“…The early nutritional intervention associated with the low percentage of severe cases in the sample may explain why the number of malnourished children in our sample was lower than that reported in other similar investigations. Our study demonstrates 28.8% of malnutrition, while others who evaluated the nutritional status in a similar way as Saron et al [19], Baran et al [20] and Zamberlan et al [21] showed percentages between 40 and 50.…”

Avaliação Nutricional Em Crianças E Adolescentes Com Cirrose: Estudo Transversal De Duas Séries

“…Foram encontrados sete artigos com menos de 10 anos de publicação passíveis de comparação com o presente estudo: quatro brasileiros [15][16][17][18] e três internacionais [19][20][21] . Esses estudos utilizaram os índices E/I e/ou DCT/I para a classificação do estado nutricional e os modelos PELD e/ou MELD e/ou o escore Child-Pugh para a classificação da gravidade da doença.…”

Single-Nucleotide Polymorphism at CYP27B1-1260, but Not VDR Taq I, Is Possibly Associated with Persistent Hepatitis B Virus Infection

“…In view of the preventive and beneficial effect of 1,25(OH) 2 D on both autoimmune diseases and viral infections (Saron et al, 2009;Petta et al, 2010), it seems that the predisposing effect of genetic variation in the CYP27B1 gene may be exerted through the downregulation of 1,25(OH) 2 D levels. However, different immunological mechanisms are involved in autoimmune disorders and nonautoimmune diseases such as viral infections.…”

“…In view of this, vitamin D deficiency has been proposed to be involved in autoimmune disorders, metabolic diseases, chronic viral infection, and tumors, including those affecting liver such as autoimmune hepatitis (Saron et al, 2009), alcoholic liver disease (Malham et al, 2011), nonalcoholic fat liver disease (Targher et al, 2007;Barchetta et al, 2011), chronic hepatitis C virus (HCV) infection (Arteh et al, 2010;Petta et al, 2010), and HCC (Chiang et al, 2011).…”