Low Bone Mineral Density and the Severity of Cholestasis in Biliary Atresia

Overview

Journal World J Hepatol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2017 Jun 28

PMID 28652893

Citations 2

Authors

Krittapak Homchan

Tawatchai Chaiwatanarat

Wanvisa Udomsinprasert

Voranush Chongsrisawat

Yong Poovorawan

Sittisak Honsawek

Affiliations

Soon will be listed here.

Abstract

Aim: 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.

Methods: 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.

Results: 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 ( = 0.774, < 0.001), serum albumin ( = 0.333, = 0.005), total bilirubin ( = -0.476, < 0.001), aspartate aminotransferase ( = -0.583, < 0.001), alanine aminotransferase ( = -0.428, < 0.001), and alkaline phosphatase( = -0.456, < 0.001).

Conclusion: Low BMD was associated with biochemical parameters reflecting the severity of cholestasis in postKasai BA patients.

Citing Articles

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PMID: 36142636 PMC: 9503777. DOI: 10.3390/ijms231810705.

Associations between Vitamin D and Liver Function and Liver Fibrosis in Patients with Biliary Atresia.

Zhuang P, Sun S, Dong R, Chen G, Huang Y, Zheng S Gastroenterol Res Pract. 2019; 2019:4621372.

PMID: 31781188 PMC: 6875370. DOI: 10.1155/2019/4621372.

References

Honsawek S, Chaiwatanarat T, Chongsrisawat V, Thawornsuk N, Vejchapipat P, Poovorawan Y . Circulating leptin levels and bone mineral density in children with biliary atresia. Acta Paediatr. 2008; 97(2):206-11. DOI: 10.1111/j.1651-2227.2007.00596.x. View

Bassett M, Murray K . Biliary atresia: recent progress. J Clin Gastroenterol. 2008; 42(6):720-9. PMC: 4035350. DOI: 10.1097/MCG.0b013e3181646730. View

Pusl T, Beuers U . Extrahepatic manifestations of cholestatic liver diseases: pathogenesis and therapy. Clin Rev Allergy Immunol. 2005; 28(2):147-57. DOI: 10.1385/CRIAI:28:2:147. View

Janes C, Dickson E, Okazaki R, Bonde S, McDonagh A, Riggs B . Role of hyperbilirubinemia in the impairment of osteoblast proliferation associated with cholestatic jaundice. J Clin Invest. 1995; 95(6):2581-6. PMC: 295940. DOI: 10.1172/JCI117959. View

Hartley J, Davenport M, Kelly D . Biliary atresia. Lancet. 2009; 374(9702):1704-13. DOI: 10.1016/S0140-6736(09)60946-6. View

Teisseyre M, Pawlowska J, Kryskiewicz E, Karczmarewicz E, Czubkowski P, Dadalski M . Bone mineral metabolism in children with biliary atresia after living related liver transplantation. Evaluation of selected parameters. Ann Transplant. 2008; 12(2):19-25. View

Chongsrisawat V, Ruttanamongkol P, Chaiwatanarat T, Chandrakamol B, Poovorawan Y . Bone density and 25-hydroxyvitamin D level in extrahepatic biliary atresia. Pediatr Surg Int. 2001; 17(8):604-8. DOI: 10.1007/s003830100003. View

A-Kader H, Abdel-Hameed A, Al-Shabrawi M, Mohsen N, El-Karaksy H, Hassanein B . Is biliary atresia an autoimmune disease?. Eur J Gastroenterol Hepatol. 2003; 15(4):447. DOI: 10.1097/00042737-200304000-00020. View

Kobayashi H, Stringer M . Biliary atresia. Semin Neonatol. 2004; 8(5):383-91. DOI: 10.1016/S1084-2756(03)00065-4. View

10.

Okada T, Honda S, Miyagi H, Minato M, Taketomi A . Hepatic osteodystrophy complicated with bone fracture in early infants with biliary atresia. World J Hepatol. 2013; 4(10):284-7. PMC: 3537162. DOI: 10.4254/wjh.v4.i10.284. View

11.

Rouillard S, Lane N . Hepatic osteodystrophy. Hepatology. 2000; 33(1):301-7. DOI: 10.1053/jhep.2001.20533. View

12.

Balistreri W, Grand R, Hoofnagle J, Suchy F, Ryckman F, Perlmutter D . Biliary atresia: current concepts and research directions. Summary of a symposium. Hepatology. 1996; 23(6):1682-92. DOI: 10.1002/hep.510230652. View

13.

Sanchez A, Aranda-Michel J . Liver disease and osteoporosis. Nutr Clin Pract. 2006; 21(3):273-8. DOI: 10.1177/0115426506021003273. View

14.

Erlichman J, Hohlweg K, Haber B . Biliary atresia: how medical complications and therapies impact outcome. Expert Rev Gastroenterol Hepatol. 2009; 3(4):425-34. DOI: 10.1586/egh.09.30. View

15.

Honsawek S, Chaiwatanarat T, Vejchapipat P, Chongsrisawat V, Thawornsuk N, Poovorawan Y . Relationships between OPG, RANKL, bone metabolism, and bone mineral density in biliary atresia. Pediatr Surg Int. 2009; 25(3):261-7. DOI: 10.1007/s00383-009-2325-y. View

16.

Ruiz-Gaspa S, Dubreuil M, Guanabens N, Combalia A, Peris P, Monegal A . Ursodeoxycholic acid decreases bilirubin-induced osteoblast apoptosis. Eur J Clin Invest. 2014; 44(12):1206-14. DOI: 10.1111/eci.12355. View