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

Krittapak Homchan1, Tawatchai Chaiwatanarat1, Wanvisa Udomsinprasert1

  • 1Krittapak Homchan, Voranush Chongsrisawat, Yong Poovorawan, Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.

World Journal of Hepatology
|June 28, 2017
PubMed

Insights

Over half of children with biliary atresia (BA) show low bone mass after surgery. Persistent jaundice in these patients is linked to lower bone mineral density (BMD) and poorer bone health outcomes.

Area of Science:

  • Pediatric Gastroenterology
  • Hepatology
  • Pediatric Endocrinology

Background:

  • Biliary atresia (BA) is a severe neonatal liver disease requiring surgical intervention (Kasai procedure).
  • Postoperative BA patients are at risk for complications, including impaired bone health.

Purpose of the Study:

  • To determine the prevalence of osteopenia and osteoporosis in children following the Kasai procedure for BA.
  • To explore the relationship between bone mineral density (BMD) and various biochemical markers in these patients.

Main Methods:

  • A prospective study involving 70 post-Kasai BA patients.
  • Classification into jaundice and non-jaundice groups.
  • Lumbar spine BMD assessment using dual-energy X-ray absorptiometry (DXA).

Main Results:

  • A high prevalence of low bone mass (osteopenia and osteoporosis) was observed in 51.4% of BA patients.
  • Patients with persistent jaundice exhibited significantly lower lumbar spine BMD Z-scores and lower serum 25-hydroxyvitamin D levels.
  • BMD correlated with age, serum albumin, and liver function tests (total bilirubin, AST, ALT, alkaline phosphatase), indicating a link to cholestasis severity.

Conclusions:

  • Low bone mineral density is common in children with biliary atresia after the Kasai procedure.
  • Persistent cholestasis and associated biochemical derangements significantly impact bone health in these patients.
Abstract

Keywords:
Biliary atresiaBone mineral densityCholestasisJaundiceSeverity

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