Related Experiment Video
Updated: May 15, 2025
A Silver Nanoparticle Method for Ameliorating Biliary Atresia Syndrome in Mice
Published on: October 13, 2018
Non-invasive simple predictors of biliary atresia in cholestatic infants - A preliminary report
Yu-Hsueh Hsiao1, Wei-Li Hung2, Yao-Jong Yang3
1Departments of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Insights
A simple non-invasive test, GGT*D-bil, can help diagnose biliary atresia (BA) in infants with cholestasis. A GGT*D-bil level above 510 mg*U/dL.L shows high accuracy in identifying BA, aiding early diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Neonatal Hepatology
- Diagnostic Biomarkers
Background:
- Biliary atresia (BA) and other infantile cholestatic liver diseases present with similar clinical signs.
- Accurate and timely differential diagnosis is crucial for optimal infant outcomes.
- Non-invasive diagnostic tools are needed to aid clinicians in distinguishing BA.
Purpose of the Study:
- To evaluate the utility of non-invasive parameters in differentiating BA from other cholestatic liver diseases in infants.
- To identify an easily applicable biochemical marker for BA diagnosis.
Main Methods:
- A retrospective cross-sectional study involving 145 infants in a primary cohort and 27 in a validation cohort.
- Analysis of clinical data and laboratory tests, focusing on the "GGT*D-bil" parameter.
- Receiver operating characteristic (ROC) curve analysis to determine the optimal cutoff value.
Main Results:
- The "GGT*D-bil" parameter was significantly elevated in infants with BA compared to non-BA cholestatic infants (p < 0.001).
- An optimal cutoff of "GGT*D-bil" > 510 mg*U/dL.L demonstrated high predictive value (92% AUC) in the study cohort.
- This cutoff achieved 100% sensitivity and high negative predictive value (NPV) in the study cohort, and good sensitivity (92.31%) and NPV (90.91%) in the validation cohort.
Conclusions:
- The "GGT*D-bil" parameter serves as a valuable, non-invasive tool to assist in the diagnosis of BA in cholestatic infants.
- This simple biochemical marker can be readily integrated into routine cholestatic workups, regardless of hospital resources.
- Early and accurate diagnosis of BA using "GGT*D-bil" can facilitate prompt treatment and improve infant prognosis.
Background:
Biliary atresia (BA) and other cholestatic liver diseases of early infancy share many similar clinical manifestations. We intended to investigate easy and popular non-invasive parameters to assist the differential diagnosis of BA among cholestatic infants.
Methods:
We enrolled 145 consecutive cholestatic infants (43.03 ± 2.00 days) who underwent cholestatic workups at our hospital as the study cohort, and another 27 cholestatic infants (47.78 ± 13.33 days) who received their initial cholestatic workups and laboratory tests at four other 4 hospitals as the validation cohort. The clinical data were surveyed retrospectively using a cross-sectional design.
Results:
We demonstrated that the "GGT∗D-bil" was significantly higher in the BA group than in the non-BA group in the study cohort (p < 0.001). The Receiver operating characteristic curve analysis of the study cohort identified the "GGT∗D-bil" cutoff >510 mg U/dL.L for the best prediction of BA among cholestatic infants (92 % area under the curve, p < 0.001). The sensitivity and negative predictive value (NPV) for predicting BA among cholestatic infants are 100 % in the study cohort. In the validation cohort, the "GGT∗D-bil" > 510 mg U/dL.L also achieved good sensitivity and NPV (92.31 % and 90.91 %, respectively) for the prediction of BA.
Conclusions:
We demonstrated that an easy parameter, "GGT∗D-bil" > 510 mg U/dL.L, may be used as part of the non-invasive cholestatic workups to assist in the diagnosis of BA among cholestatic infants in our study and validation cohorts. The application of this parameter is easy and not limited by the resources of the hospitals.
