胆道闭锁中低骨矿物质密度与胆汁淤积严重程度的关系

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

作者信息

Homchan Krittapak, Chaiwatanarat Tawatchai, Udomsinprasert Wanvisa, Chongsrisawat Voranush, Poovorawan Yong, Honsawek Sittisak

机构信息

Krittapak 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.

出版信息

World J Hepatol. 2017 Jun 8;9(16):746-751. doi: 10.4254/wjh.v9.i16.746.

DOI:10.4254/wjh.v9.i16.746

PMID:28652893

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5468343/

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.

摘要

目的

探讨术后胆道闭锁（BA）患儿骨质疏松症和骨质减少症的患病率，以及Kasai术后BA患者骨密度（BMD）与生化参数之间的关系。

方法

本前瞻性研究共纳入70例Kasai术后BA患者。根据黄疸状态将患者分为两组。采用双能X线吸收法分析腰椎骨密度。

结果

BA患者低骨量（骨质疏松症和骨质减少症）的患病率为51.4%（70例中的36例）。黄疸组10例患者（35.7%）和非黄疸组8例患者（19.0%）患有骨质减少症。黄疸组16例患者（57.1%）和非黄疸组2例患者（4.8%）患有骨质疏松症。此外，与非黄疸患者相比，黄疸BA患者的腰椎骨密度Z值显著更低。持续黄疸的BA患者血清25-羟基维生素D显著低于无黄疸患者。进一步分析显示，腰椎骨密度与年龄（r = 0.774，P < 0.001）、血清白蛋白（r = 0.333，P = 0.005）、总胆红素（r = -0.476，P < 0.001）、天冬氨酸转氨酶（r = -0.583，P < 0.001）、丙氨酸转氨酶（r = -0.428，P < 0.001）和碱性磷酸酶（r = -0.456，P < 0.001）相关。