Bone density and 25-hydroxyvitamin D level in extrahepatic biliary atresia

Area of Science:

• Pediatric Gastroenterology
• Hepatology
• Pediatric Endocrinology

Background:

• Biliary atresia (BA) is a common cholestatic liver disease in infants and children.
• Bone disease is a known complication in long-term survivors of BA, but its pathogenesis is unclear.

Purpose of the Study:

• To evaluate bone mineral content and serum 25-hydroxyvitamin D (HVD) levels in children with extrahepatic BA.
• To compare bone health between jaundiced and non-jaundiced BA patients.

Main Methods:

• Physical examination, anthropometric nutritional assessment, and liver function tests.
• Measurement of serum calcium (Ca), phosphate (P), magnesium (Mg), and 25-hydroxyvitamin D (HVD).
• Dual-energy X-ray absorptiometry (DXA) for lumbar spine bone mineral density (BMD) assessment in 42 BA patients (20 jaundiced, 22 non-jaundiced).

Main Results:

• Osteoporosis was significantly more frequent in jaundiced BA patients (80%) compared to non-jaundiced patients (13.6%).
• All patients had normal serum Ca and P levels; only one non-jaundiced patient had low serum Mg.
• Lower serum 25-HVD levels correlated with decreased bone mineral density (osteopenia and osteoporosis).

Conclusions:

• Jaundiced BA patients are at higher risk for developing osteoporosis, suggesting hyperbilirubinemia may play a role.
• BMD measurement is a valuable non-invasive method for early detection of bone mineral deficiency in BA patients.
• Bone-mineral deficiency is a significant concern in BA survivors, necessitating further investigation into its causes and management.