Relationship of Serum Vitamin D with Liver Disease Severity and  Bone Abnormalities in Cholestatic Children

Evangeline P.  Capul; Germana Emerita V.  Gregorio; Jarold P.  Pauig

doi:10.47895/amp.vi0.3148

Evangeline P. Capul Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Philippine General Hospital,University of the Philippines Manila, Manila, Philippines
Germana Emerita V. Gregorio Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Philippine General Hospital,University of the Philippines Manila, Manila, Philippines
Jarold P. Pauig Department of Radiology, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines

DOI: https://doi.org/10.47895/amp.vi0.3148

Keywords: Vitamin D, rickets, cholestasis, bone disease, bone abnormalities

Abstract

Background. Vitamin D deficiency occurs in 10% to 36% of children with cholestasis. The relationship between serum vitamin D levels, severity of liver disease and bone abnormalities in children has not been extensively investigated.

Objective. To determine serum vitamin D levels and its association with liver disease severity and presence of radiographic rickets in children with cholestasis.

Methodology. Children aged 0–10 years with cholestasis underwent serum 25-hydroxyvitamin D levels (25-[OH]D) determination, radiographs of wrists and knees and liver function tests. Liver disease severity was evaluated using the Child-Pugh score. Radiographs were assessed using Thacher Rickets Severity Score. Data were analyzed using odds ratio and Spearman’s correlation coefficient.

Results. We included 51 children [Mean (SD) age: 5 (6) months, 63% are males], mostly with biliary atresia (51%). Forty-seven (92%) had serum 25-(OH)D deficiency and four (8%) had insufficiency. Radiologic bone abnormalities were observed in 22 (43%) cases; specifically, rickets in 16 (31%). No association was observed with vitamin D levels and liver disease severity (OR 1.27, 95% CI 0.12–13.31) nor with rickets score (OR 0.07, 95% CI 0.004–1.37).

Conclusion. Majority of the children with cholestasis had vitamin D deficiency, with a third having radiographic findings of rickets. Serum vitamin D levels were not associated with liver disease severity or with rickets score.