PEDIATRICS Vol. 91 No. 6 June 1993, pp. 1151-1154
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Argao, E. A.
Right arrow Articles by Heubi, J. E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Argao, E. A.
Right arrow Articles by Heubi, J. E.

Bone Mineral Content in Infants and Children With Chronic Cholestatic Liver Disease

Eric A. Argao MD1, Bonny L. Specker PhD1, and James E. Heubi MD1

1 From the Division of Gastroenterology and Nutrition, Children's Hospital Research Foundation and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.

Objective. To assess bone mineral content (BMC) status and serum vitamin D metabolite levels of infants and children with chronic cholestatic liver disease. To determine if severity of bone disease in these patients correlates with serum vitamin D metabolite levels.

Methodology. We measured radial BMC with the use of a single-beam photon absorptiometer and serum vitamin D metabolite levels in 56 patients with chronic cholestasis seen at our institution from 1985 through 1991. Patients were divided into two groups according to age.

Results. In group 1 (n = 37; age 2 to 22 months), decreased levels of BMC were seen as early as the first few months of life, with sharp decline observed with increasing age (approaching 3 to 5 standard deviations [SD] below the mean, P < .0003). Older patients (group 2, n = 19; age 2 to 20 years) had BMC values which clustered between 2 and 4 SD below the mean throughout the age range. Although a downward trend also was noted with increasing age, this was not statistically significant. Despite correction for weight-age or height-age, BMC was decreased in most of these patients. No correlation between severity of osteopenia and serum levels of 25(OH)-vitamin D and 1,25(OH)2-vitamin D was observed in either infants or older children.

Conclusions. Decreased bone mineralization, as a complication of chronic cholestatic conditions, is a disease process that begins early in infancy, rapidly worsens with increasing age and hepatic dysfunction, and remains relatively stable in children with more stable liver disease.

Key Words: metabolic bone disease • bone density • bone mineral content • chronic cholestatic disease • vitamin D

Submitted on July 15, 1992
Accepted on January 26, 1993




This article has been cited by other articles:


Home page
 J Child Health CareHome page
R. M. Taylor, L. S. Franck, F. Gibson, and A. Dhawan
Liver transplantation in children: part 2 - long-term issues
J Child Health Care, December 1, 2005; 9(4): 274 - 287.
[Abstract] [PDF]