Prevalence of Fat-Soluble Vitamin Deficiency in Post Hepaticoportoenterostomy Biliary Atresia Patients

Abstract

Abstract Purpose To primarily evaluate the prevalence of fat-soluble vitamin (FSV) deficiency in children with EHBA. The secondary objective was to explore any possible associated risk factors. Methods FSV deficiency was diagnosed if either 1) vitamin A level < 0.7 micromol/L, 2) serum 25-OH D < 20 ng/mL, 3) vitamin E to cholesterol ratio < 2.22 micromol/mmol, or 4) INR > 1.5 correctable with parenteral vitamin K administration. Results Thirty EHBA patients (13 males) with an average age of 7.9 years old were consecutively enrolled. The prevalence of at least one FSV deficiency was 36.7% (95% CI 18.4, 54.9), in which the most common one was vitamin A deficiency (36.7%), followed by the deficiency of vitamin D, E, and K, respectively. Univariate analysis showed statistically significant differences in hepatomegaly, albumin, total bilirubin, direct bilirubin, hemoglobin level, anemia for ages, ESR, CRP, BUN, creatinine level, and PELD score between those with and without any FSV deficiency. Conclusion Vitamin A deficiency was the most frequently observed. Adequate vitamin supplementation should be carefully reviewed to prevent its deficiency, particularly in EHBA patients with high PELD scores, potentially indicative of LT.