Total serum bilirubin predicts fat-soluble vitamin deficiency better than serum bile acids in infants with biliary atresia

Childhood Liver Disease Research and Education Network (ChiLDReN)

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Methods: Infants enrolled in the Trial of Corticosteroid Therapy in Infants with Biliary Atresia after hepatoportoenterostomy were the subjects of this investigation. Infants received standardized FSV supplementation and monitoring of TB, SBA, and vitamin levels at 1, 3, and 6 months. A logistic regression model was used with the binary indicator variable insufficient/sufficient as the outcome variable. Linear and nonparametric correlations were made between specific vitamin measurement levels and either TB or SBA.

Results: The degree of correlation for any particular vitamin at a specific time point was higher with TB than with SBA (higher for TB in 31 circumstances vs 3 circumstances for SBA). Receiver operating characteristic curve shows that TB performed better than SBA (area under the curve 0.998 vs 0.821). Including both TB and SBA did not perform better than TB alone (area under the curve 0.998).

Conclusions: We found that TB was a better predictor of FSV deficiency than SBA in infants with biliary atresia. The role of SBA as a surrogate marker of FSV deficiency in other cholestatic liver diseases, such as progressive familial intrahepatic cholestasis, α-1-antitrypsin deficiency, and Alagille syndrome in which the pathophysiology is dominated by intrahepatic cholestasis, warrants further study.

Objective: Fat-soluble vitamin (FSV) deficiency is a well-recognized consequence of cholestatic liver disease and reduced intestinal intraluminal bile acid. We hypothesized that serum bile acid (SBA) would predict biochemical FSV deficiency better than serum total bilirubin (TB) level in infants with biliary atresia.

Original languageEnglish
Pages (from-to)702-707
Number of pages6
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume59
Issue number6
DOIs
StatePublished - Dec 11 2014

Fingerprint

Avitaminosis
Biliary Atresia
Bile Acids and Salts
Bilirubin
Fats
Serum
Vitamins
Area Under Curve
Liver Diseases
Alagille Syndrome
Logistic Models
Intrahepatic Cholestasis
ROC Curve
Adrenal Cortex Hormones
Biomarkers

Keywords

  • Biliary atresia
  • Bilirubin
  • Cholestasis
  • Fat-soluble vitamin
  • Serum bile acid

ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

Cite this

Total serum bilirubin predicts fat-soluble vitamin deficiency better than serum bile acids in infants with biliary atresia. / Childhood Liver Disease Research and Education Network (ChiLDReN).

In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 59, No. 6, 11.12.2014, p. 702-707.

Research output: Contribution to journalArticle

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abstract = "Methods: Infants enrolled in the Trial of Corticosteroid Therapy in Infants with Biliary Atresia after hepatoportoenterostomy were the subjects of this investigation. Infants received standardized FSV supplementation and monitoring of TB, SBA, and vitamin levels at 1, 3, and 6 months. A logistic regression model was used with the binary indicator variable insufficient/sufficient as the outcome variable. Linear and nonparametric correlations were made between specific vitamin measurement levels and either TB or SBA.Results: The degree of correlation for any particular vitamin at a specific time point was higher with TB than with SBA (higher for TB in 31 circumstances vs 3 circumstances for SBA). Receiver operating characteristic curve shows that TB performed better than SBA (area under the curve 0.998 vs 0.821). Including both TB and SBA did not perform better than TB alone (area under the curve 0.998).Conclusions: We found that TB was a better predictor of FSV deficiency than SBA in infants with biliary atresia. The role of SBA as a surrogate marker of FSV deficiency in other cholestatic liver diseases, such as progressive familial intrahepatic cholestasis, α-1-antitrypsin deficiency, and Alagille syndrome in which the pathophysiology is dominated by intrahepatic cholestasis, warrants further study.Objective: Fat-soluble vitamin (FSV) deficiency is a well-recognized consequence of cholestatic liver disease and reduced intestinal intraluminal bile acid. We hypothesized that serum bile acid (SBA) would predict biochemical FSV deficiency better than serum total bilirubin (TB) level in infants with biliary atresia.",
keywords = "Biliary atresia, Bilirubin, Cholestasis, Fat-soluble vitamin, Serum bile acid",
author = "{Childhood Liver Disease Research and Education Network (ChiLDReN)} and Venkat, {Veena L.} and Shneider, {Benjamin L.} and Magee, {John C.} and Yumirle Turmelle and Ronen Arnon and Bezerra, {Jorge A.} and Hertel, {Paula M.} and Karpen, {Saul J.} and Nanda Kerkar and Loomes, {Kathleen M.} and Jean Molleston and Murray, {Karen F.} and Ng, {Vicky L.} and Trivellore Raghunathan and Philip Rosenthal and Kathleen Schwartz and Sherker, {Averell H.} and Sokol, {Ronald J.} and Jeffrey Teckman and Kasper Wang and Whitington, {Peter F.} and Heubi, {James E.}",
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T1 - Total serum bilirubin predicts fat-soluble vitamin deficiency better than serum bile acids in infants with biliary atresia

AU - Childhood Liver Disease Research and Education Network (ChiLDReN)

AU - Venkat, Veena L.

AU - Shneider, Benjamin L.

AU - Magee, John C.

AU - Turmelle, Yumirle

AU - Arnon, Ronen

AU - Bezerra, Jorge A.

AU - Hertel, Paula M.

AU - Karpen, Saul J.

AU - Kerkar, Nanda

AU - Loomes, Kathleen M.

AU - Molleston, Jean

AU - Murray, Karen F.

AU - Ng, Vicky L.

AU - Raghunathan, Trivellore

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AU - Schwartz, Kathleen

AU - Sherker, Averell H.

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AU - Whitington, Peter F.

AU - Heubi, James E.

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N2 - Methods: Infants enrolled in the Trial of Corticosteroid Therapy in Infants with Biliary Atresia after hepatoportoenterostomy were the subjects of this investigation. Infants received standardized FSV supplementation and monitoring of TB, SBA, and vitamin levels at 1, 3, and 6 months. A logistic regression model was used with the binary indicator variable insufficient/sufficient as the outcome variable. Linear and nonparametric correlations were made between specific vitamin measurement levels and either TB or SBA.Results: The degree of correlation for any particular vitamin at a specific time point was higher with TB than with SBA (higher for TB in 31 circumstances vs 3 circumstances for SBA). Receiver operating characteristic curve shows that TB performed better than SBA (area under the curve 0.998 vs 0.821). Including both TB and SBA did not perform better than TB alone (area under the curve 0.998).Conclusions: We found that TB was a better predictor of FSV deficiency than SBA in infants with biliary atresia. The role of SBA as a surrogate marker of FSV deficiency in other cholestatic liver diseases, such as progressive familial intrahepatic cholestasis, α-1-antitrypsin deficiency, and Alagille syndrome in which the pathophysiology is dominated by intrahepatic cholestasis, warrants further study.Objective: Fat-soluble vitamin (FSV) deficiency is a well-recognized consequence of cholestatic liver disease and reduced intestinal intraluminal bile acid. We hypothesized that serum bile acid (SBA) would predict biochemical FSV deficiency better than serum total bilirubin (TB) level in infants with biliary atresia.

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KW - Cholestasis

KW - Fat-soluble vitamin

KW - Serum bile acid

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