Published online Jun 8, 2017. doi: 10.4254/wjh.v9.i16.746
Peer-review started: February 12, 2017
First decision: March 28, 2017
Revised: April 19, 2017
Accepted: May 12, 2017
Article in press: May 15, 2017
Published online: June 8, 2017
To investigate the prevalence of osteopenia and osteoporosis in postoperative biliary atresia (BA) children and the association of bone mineral density (BMD) and biochemical parameters in postKasai BA subjects.
A total of 70 patients with postKasai BA were enrolled in this prospective study. The patients were classified into two groups according to their jaundice status. BMD of the lumbar spine was analyzed using dual energy X-ray absorptiometry.
The prevalence of low bone mass (osteopenia and osteoporosis) in BA patients were 51.4% (36 out of 70). Ten patients (35.7%) in the jaundice group and 8 patients (19.0%) in the non-jaundice group had osteopenia. Sixteen patients (57.1%) in the jaundice group and 2 patients (4.8%) in the no jaundice group had osteoporosis. In addition, lumbar spine BMD Z-score was substantially lower in the jaundice BA patients compared with non-jaundice patients. BA subjects with persistent jaundice had significantly lower serum 25-hydroxyvitamin D than those without jaundice. Further analysis revealed that lumbar spine BMD was correlated with age (r = 0.774, P < 0.001), serum albumin (r = 0.333, P = 0.005), total bilirubin (r = -0.476, P < 0.001), aspartate aminotransferase (r = -0.583, P < 0.001), alanine aminotransferase (r = -0.428, P < 0.001), and alkaline phosphatase(r = -0.456, P < 0.001).
Low BMD was associated with biochemical parameters reflecting the severity of cholestasis in postKasai BA patients.
Core tip: Recent evidences have highlighted the importance of bone mineral density (BMD) in chronic liver disease including biliary atresia (BA). This study revealed that BA patients with persistent jaundice had significantly lower BMD and 25-hydroxyvitamin D than those without jaundice. Furthermore, lumbar spine BMD was correlated with hepatic dysfunction suggesting that low BMD was associated with outcome parameters reflecting the severity of cholestasis in postoperative BA patients.