Bone health in a nonjaundiced population of children with biliary atresia.
OBJECTIVE
To assess bone health in a cohort of nonjaundiced children with biliary atresia (BA) and the effect of growth and development on bone outcomes.


METHODS
Children ages one to eighteen years receiving care from Children's Hospital of Philadelphia were recruited. Each child was seen once and assessed for growth, pubertal development, concurrent medications, bilirubin, ALT, albumin, vitamin D status, bone mineral density (BMD), and bone mineral content (BMC) of the lumbar spine and whole body.


RESULTS
BMD declined significantly with age, and upon further analysis with a well-phenotyped control cohort, it was found that BMC was significantly decreased for both lumbar spine and whole body, even after adjustment for confounding variables. An age interaction was identified, with older subjects having a significantly greater impairment in BMC.


CONCLUSIONS
These preliminary results demonstrate that children with BA, including those without jaundice, are likely to have compromised bone health even when accounting for height and puberty, which are common confounding factors in chronic disease. Further investigation is needed to identify the determinants of poor bone mineral status and to develop strategies to prevent osteoporosis later in life.
Kramer
Rachel A
RA
The Division of Gastroenterology, Hepatology & Nutrition, Children's Hospital of Philadelphia, PA 19104, USA.
Zemel
Babette S
BS
Arvay-Nezu
Jessica L
JL
Stallings
Virginia A
VA
Leonard
Mary B
MB
Haber
Barbara A
BA