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Zinc status and its relations to growth retardation in children with biliary atresia
Insights
Children with biliary atresia often have low zinc levels (hypozincemia), which can worsen without supplementation. Monitoring and zinc supplementation are crucial for growth in these patients.
Area of Science:
- Pediatric Gastroenterology
- Nutritional Science
- Surgical Pediatrics
Background:
- Biliary atresia is a severe neonatal liver disease affecting bile duct drainage.
- Zinc deficiency (hypozincemia) is a potential complication in pediatric gastrointestinal and liver conditions.
- Hirschsprung's disease and anorectal anomalies are congenital conditions affecting the lower digestive tract.
Purpose of the Study:
- To investigate zinc status in children with biliary atresia and compare it with children with Hirschsprung's disease or anorectal anomalies.
- To analyze changes in plasma and urinary zinc levels pre- and post-operatively.
- To assess the relationship between zinc status, liver function, bile excretion, and growth in biliary atresia.
Main Methods:
- Cross-sectional study of zinc status in 36 children with biliary atresia and 10 with Hirschsprung's disease/anorectal anomalies.
- Measurement of preoperative and postoperative plasma and urinary zinc levels in subsets of patients.
- Longitudinal follow-up of 20 children with biliary atresia (9 months to 10 years).
Main Results:
- Preoperative hypozincemia was observed in children with biliary atresia.
- Zinc levels decreased over time in biliary atresia patients without adequate supplementation.
- Children with poor bile excretion and impaired liver function showed hypozincemia and high urinary zinc excretion, correlating with growth retardation.
Conclusions:
- Zinc deficiency is prevalent in children with biliary atresia and requires attention.
- Impaired bile excretion and liver function in biliary atresia are associated with altered zinc metabolism.
- Monitoring and appropriate zinc supplementation are vital for promoting normal growth in pediatric patients with biliary atresia.
Abstract:
Zinc status was studied in 36 children with biliary atresia and in ten children with Hirschsprung's disease or anorectal anomalies. Changes in preoperative and postoperative plasma and urinary zinc levels were measured in 16 children with biliary atresia and ten children with Hirschsprung's disease or anorectal anomalies. Hypozincemia was evident in children with biliary atresia preoperatively and became severe with time when adequate zinc supplementation was not given. Follow-up studies were done in 20 children with biliary atresia aged between 9 months to 10 years. The children with poor bile excretion and impaired liver function tended to have hypozincemia and a high excretion of zinc. Growth retardation was also common in these children. Careful monitoring and appropriate supplementation of micronutrients, including zinc is probably important for normal growth in children with biliary atresia.