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Bone health in a nonjaundiced population of children with biliary atresia

Rachel A Kramer1, Babette S Zemel, Jessica L Arvay-Nezu

  • 1The Division of Gastroenterology, Hepatology & Nutrition, Children's Hospital of Philadelphia, PA 19104, USA.

Gastroenterology Research and Practice
|July 17, 2009
PubMed

Insights

Children with biliary atresia (BA) have poor bone health, even without jaundice. Bone mineral content (BMC) is significantly decreased, especially in older children, indicating a need for early intervention.

Area of Science:

  • Pediatric Gastroenterology
  • Pediatric Endocrinology
  • Bone Metabolism

Background:

  • Biliary atresia (BA) is a serious neonatal liver disease.
  • Bone health complications in children with BA are not well understood, particularly in nonjaundiced patients.
  • Growth and pubertal development can influence bone outcomes in chronic conditions.

Purpose of the Study:

  • To evaluate bone health in nonjaundiced children with BA.
  • To determine the impact of growth and development on bone mineral density (BMD) and bone mineral content (BMC) in this cohort.

Main Methods:

  • A cohort of 1-18 year olds with BA was assessed at a single visit.
  • Measurements included growth, pubertal status, medications, liver function tests, vitamin D levels, BMD, and BMC (lumbar spine and whole body).
  • A control group was used for comparative analysis.

Main Results:

  • BMD significantly declined with increasing age.
  • Children with BA had significantly lower lumbar spine and whole body BMC compared to controls, even after adjusting for confounders.
  • Older children with BA exhibited a more pronounced deficit in BMC.

Conclusions:

  • Children with BA, irrespective of jaundice status, exhibit compromised bone health.
  • Height and puberty do not fully explain the observed bone mineral deficits.
  • Further research is crucial to identify causes and develop preventative strategies for osteoporosis in BA patients.
Abstract

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