Low bone mineral density and the severity of cholestasis in biliary atresia

Abstract

AIMTo investigate the prevalence of osteopenia and osteoporosis in postoperative biliary atresia (BA) children and the association of bone mineral density (BMD) and biochemical parameters in postKasai BA subjects.METHODSA total of 70 patients with postKasai BA were enrolled in this prospective study. The patients were classified into two groups according to their jaundice status. BMD of the lumbar spine was analyzed using dual energy X-ray absorptiometry.RESULTSThe prevalence of low bone mass (osteopenia and osteoporosis) in BA patients were 51.4% (36 out of 70). Ten patients (35.7%) in the jaundice group and 8 patients (19.0%) in the non-jaundice group had osteopenia. Sixteen patients (57.1%) in the jaundice group and 2 patients (4.8%) in the no jaundice group had osteoporosis. In addition, lumbar spine BMD Z-score was substantially lower in the jaundice BA patients compared with non-jaundice patients. BA subjects with persistent jaundice had significantly lower serum 25-hydroxyvitamin D than those without jaundice. Further analysis revealed that lumbar spine BMD was correlated with age (r = 0.774, P < 0.001), serum albumin (r = 0.333, P = 0.005), total bilirubin (r = -0.476, P < 0.001), aspartate aminotransferase (r = -0.583, P < 0.001), alanine aminotransferase (r = -0.428, P < 0.001), and alkaline phosphatase(r = -0.456, P < 0.001).CONCLUSIONLow BMD was associated with biochemical parameters reflecting the severity of cholestasis in postKasai BA patients.

Associations between Vitamin D and Liver Function and Liver Fibrosis in Patients with Biliary Atresia

“…Elevated ALP levels indicate that there could be a disease that affects blood calcium level (hyperparathyroidism), VD deficiency, or damaged liver cells [19]. ALP is closely associated with bone metabolism in postoperative BA patients [20]. The effects of VD on liver function are controversial.…”

“…In the present research, we found that VD deficiency was associated with the severity of liver fibrosis in BA patients preoperatively, suggesting that VD deficiency was involved in disease progression. Homchan et al [20] found that serum 25-(OH)D level in postoperative BA patients with jaundice was lower than those in patients without jaundice. However, there were no data regarding liver fibrosis in that study.…”