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CN 22-1108/R
Volume 41 Issue 1
Jan.  2025
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Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(1): 99-103

Level of vitamin D in children with cholestatic liver disease and its clinical features

DOI: 10.12449/JCH250115

  • Department of Traditional Chinese Medicine，Beijing Children’s Hospital，Capital Medical University，National Center for Children’s Health，Beijing 100045，China

Research funding:

National Natural Science Foundation of China (82205184);

Beijing Municipal Administration of Hospital Incubating Program (PZ2022027)

More Information
  • Corresponding author: YANG Yan， yy2303@sina.com （ORCID： 0000-0003-1070-9614）
  • Received Date: 2024-04-15
  • Accepted Date: 2024-05-29
  • Published Date: 2025-01-25
    Abstract
  •   Objective  To investigate vitamin D level in children with cholestatic liver disease， and to provide a theoretical basis for vitamin D supplementation therapy in children with this disease.  Methods  A total of 116 children with cholestatic liver disease who attended Department of Traditional Chinese Medicine， Beijing Children’s Hospital， Capital Medical University， for the first time from January 2022 to January 2024 were enrolled and divided into groups for comparison based on sex， age， vitamin D supplementation dose， course of the disease， and etiology. The data on the serum level of 25-hydroxyvitamin D （25-OH-D） and related biochemical parameters were collected to assess the correlation between vitamin D level and biochemical parameters. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups， and the Spearman rank correlation test was used for correlation analysis.  Results  Among the 116 children， 76 （65.5%） had vitamin D deficiency or insufficiency. The children with vitamin D deficiency or insufficiency accounted for 65.7% （46/70） among boys and 65.2% （30/46） among girls， with no significant difference between boys and girls （χ2=0.003， P=0.956）. The children with vitamin D deficiency or insufficiency accounted for 83.3% （25/30） among the children who had never received vitamin D supplementation， 58.7% （27/46） among the children with a daily supplementation dose of 500 IU， 64.3% （18/28） among the children with a daily supplementation dose of 700 IU， and 50.0% （6/12） among the children with a daily supplementation dose of>700 IU， and there was no significant difference between these groups （χ2=6.460， P=0.091）. Comparison between the groups with different etiologies showed that the children with vitamin D deficiency or insufficiency accounted for 57.7% （15/26） in the infectious disease group， 66.7% （10/15） in the inherited metabolic disease group， 66.7% （6/9） in the drug-induced liver injury group， 100.0% （8/8） in the group with abnormal structure of the biliary system， and 63.8% （37/58） in the group with unknown etiology， and there was no significant difference between these groups （χ2=5.304， P=0.252）. Comparison between the groups with different courses of the disease showed that the children with vitamin D deficiency or insufficiency accounted for 78.4% （29/37） in the<1 month group， 54.3% （25/46） in the 1‍ — ‍3 months group， 53.3% （8/15） in the 3‍ — ‍6 months group， and 77.8% （14/18） in the>6 months group， with no significant difference between these groups （χ2=7.432， P=0.059）. Comparison between different age groups showed that compared with the infant group， the children group had a significantly higher proportion of children with vitamin D deficiency or insufficiency （χ2=9.504， P=0.018）. The correlation analysis showed that serum aspartate aminotransferase and alanine aminotransferase had no significant correlation with 25-OH-D （P>0.05）； serum alkaline phosphatase （ALP） （r=-0.286， P=0.002）， gamma-glutamyl transpeptidase （GGT） （r=-0.248， P=0.007）， total bilirubin （TBil） （r=-0.353， P<0.001）， direct bilirubin （DBil） （r=-0.299， P=0.001）， and total bile acid （r=-0.236， P=0.011） were negatively correlated with 25-OH-D， while serum calcium （r=0.263， P=0.004） and phosphorus （r=0.385， P<0.001） were positively correlated with 25-OH-D.  Conclusion  Most children with cholestatic liver disease have vitamin D deficiency or insufficiency， and the increase in serum ALP， GGT， TBil， DBil or total bile acid and the reduction in calcium or phosphorus may suggest vitamin D deficiency or insufficiency.

     

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    • References(32)
  • [1]
    Chinese Society of Hepatology, Chinese Medical Association. Guideline on the management of cholestasis liver diseases[J]. J Clin Hepatol, 2022, 38( 1): 62- 69. DOI: 10.3760/cma.j.cn112138-20211112-00795.

    中华医学会肝病学分会. 胆汁淤积性肝病管理指南(2021年)[J]. 临床肝胆病杂志, 2022, 38( 1): 62- 69. DOI: 10.3760/cma.j.cn112138-20211112-00795
    [2]
    SHEN H, HU M, WEI ZH, et al. Bile formation, secretion, and excretion and the pathogenesis of cholestasis[J]. J Clin Hepatol, 2019, 35( 2): 431- 437. DOI: 10.3969/j.issn.1001-5256.2019.02.043.

    申弘, 胡萌, 魏泽辉, 等. 胆汁的生成、分泌、排泄及胆汁淤积发生机制[J]. 临床肝胆病杂志, 2019, 35( 2): 431- 437. DOI: 10.3969/j.issn.1001-5256.2019.02.043.
    [3]
    CHEN HL, WU SH, HSU SH, et al. Jaundice revisited: Recent advances in the diagnosis and treatment of inherited cholestatic liver diseases[J]. J Biomed Sci, 2018, 25( 1): 75. DOI: 10.1186/s12929-018-0475-8.
    [4]
    The Subspecialty Group of Infectious Diseases, The Society of Pediatrics, Chinese Medical Association; The Subspecialty Group of Gastroenterology, The Society of Pediatrics, Chinese Medical Association; The Editorial Board, Chinese Journal of Pediatrics. Expert consensus on diagnosis and treatment of infantile cholestasis[J]. Chin J Pediatr, 2022, 60( 10): 990- 997. DOI: 10.3760/cma.j.cn112140-20220505-00412.

    中华医学会儿科学分会感染学组, 中华医学会儿科学分会消化学组, 中华儿科杂志编辑委员会. 婴儿胆汁淤积症诊断与治疗专家共识[J]. 中华儿科杂志, 2022, 60( 10): 990- 997. DOI: 10.3760/cma.j.cn112140-20220505-00412.
    [5]
    HOLICK MF. The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention[J]. Rev Endocr Metab Disord, 2017, 18( 2): 153- 165. DOI: 10.1007/s11154-017-9424-1.
    [6]
    JOSHI M, UDAY S. Vitamin D deficiency in chronic childhood disorders: Importance of screening and prevention[J]. Nutrients, 2023, 15( 12): 2805. DOI: 10.3390/nu15122805.
    [7]
    GÜLŞEN M, ÖZÇAY F, BARıŞ Z, et al. Evaluation of vitamin D levels in children with liver transplant[J]. Exp Clin Transplant, 2024, 22( 2): 129- 136. DOI: 10.6002/ect.2023.0075.
    [8]
    CAI S, GONG JY, WANG JS. Clinical study on vitamin D level in infants with neonatal intrahepatic cholestasis[J]. Chin Pediatr Emerg Med, 2021, 28( 10): 922- 924. DOI: 10.3760/cma.j.issn.1673-4912.2021.10.017.

    蔡莎, 龚敬宇, 王建设. 婴儿肝内胆汁淤积症患儿维生素D水平的临床研究[J]. 中国小儿急救医学, 2021, 28( 10): 922- 924. DOI: 10.3760/cma.j.issn.1673-4912.2021.10.017.
    [9]
    TANG AQ, TANG YX, ZHANG DX, et al. Analysis on fat-soluble vitamin level of infants with cholestatic hepatopathy[J/CD]. Chin J Liver Dis(Electronic Version), 2021, 13( 3): 48- 55. DOI: 10.3969/j.issn.1674-7380.2021.03.008.

    唐爱群, 唐宇轩, 张德祥, 等. 胆汁淤积性肝病患儿脂溶性维生素水平分析[J/CD]. 中国肝脏病杂志(电子版), 2021, 13( 3): 48- 55. DOI: 10.3969/j.issn.1674-7380.2021.03.008.
    [10]
    ARTEH J, NARRA S, NAIR S. Prevalence of vitamin D deficiency in chronic liver disease[J]. Dig Dis Sci, 2010, 55( 9): 2624- 2628. DOI: 10.1007/s10620-009-1069-9.
    [11]
    LEE WS, JALALUDIN MY, WONG SY, et al. Vitamin D non-sufficiency is prevalent in children with chronic liver disease in a tropical country[J]. Pediatr Neonatol, 2019, 60( 1): 12- 18. DOI: 10.1016/j.pedneo.2018.03.011.
    [12]
    HUANG CZ, NIE BL, TANG L, et al. Correlation of severity of infantile cholestatic liver disease with serum vitamin D level[J]. J Clin Hepatol, 2019, 35( 8): 1782- 1785. DOI: 10.3969/j.issn.1001-5256.2019.08.026.

    黄彩芝, 聂波丽, 唐莲, 等. 婴儿胆汁淤积性肝病严重程度与血清维生素D水平的关系[J]. 临床肝胆病杂志, 2019, 35( 8): 1782- 1785. DOI: 10.3969/j.issn.1001-5256.2019.08.026.
    [13]
    FU XS, LI L. Research progress on the interaction between cholestatic liver disease and fat-soluble vitamins[J]. J Intern Med Concepts Pract, 2022, 17( 1): 84- 87. DOI: 10.16138/j.1673-6087.2022.01.016.

    傅小霜, 李磊. 胆汁淤积性肝病与脂溶性维生素相互作用研究进展[J]. 内科理论与实践, 2022, 17( 1): 84- 87. DOI: 10.16138/j.1673-6087.2022.01.016.
    [14]
    AL-SADAT N, MAJID HA, SIM PY, et al. Vitamin D deficiency in Malaysian adolescents aged 13 years: Findings from the Malaysian Health and Adolescents Longitudinal Research Team study(MyHeARTs)[J]. BMJ Open, 2016, 6( 8): e010689. DOI: 10.1136/bmjopen-2015-010689.
    [15]
    AN N, ZHAO YL, ZHANG GY, et al. Meta-analysis of vitamin D level in healthy Chinese children over the past 10 years[J]. Chin J Child Health Care, 2021, 29( 10): 1109- 1114. DOI: 10.11852/zgetbjzz2020-1798.

    安娜, 赵宜乐, 张古英, 等. 2010—2020年中国健康儿童维生素D水平的Meta分析[J]. 中国儿童保健杂志, 2021, 29( 10): 1109- 1114. DOI: 10.11852/zgetbjzz2020-1798.
    [16]
    YIN SA, YANG ZY. Status of vitamin A, vitamin D and comorbidity of both deficiency in Chinese children[J]. Chin J Child Health Care, 2024, 32( 3): 301- 306. DOI: 10.11852/zgetbjzz2024-0146.

    荫士安, 杨振宇. 我国儿童维生素A和维生素D营养现状及缺乏共病问题[J]. 中国儿童保健杂志, 2024, 32( 3): 301- 306. DOI: 10.11852/zgetbjzz2024-0146.
    [17]
    WACKER M, HOLICK MF. Sunlight and Vitamin D: A global perspective for health[J]. Dermatoendocrinol, 2013, 5( 1): 51- 108. DOI: 10.4161/derm.24494.
    [18]
    The Subspecialty Group of Children Health, The Society of Pediatrics, Chinese Medical Association; The Editorial Board, Chinese Journal of Pediatrics. Practical guidelines for clinical issues related to vitamin D nutrition in Chinese children[J]. Chin J Pediatr, 2022, 60( 5): 387- 394. DOI: 10.3760/cma.j.cn112140-20211230-01092.

    中华医学会儿科学分会儿童保健学组, 中华儿科杂志编辑委员会. 中国儿童维生素D营养相关临床问题实践指南[J]. 中华儿科杂志, 2022, 60( 5): 387- 394. DOI: 10.3760/cma.j.cn112140-20211230-01092.
    [19]
    Chinese Society of Osteoporosis and Bone Mineral Research, Chinese Medical Association. Consensus on the clinical applications of Vitamin D and its analogues[J]. Chin J Osteoporosis& Bone Miner Res, 2018, 11( 1): 1- 19. DOI: 10.3969/j.issn.1674-2591.2018.01.001.

    中华医学会骨质疏松和骨矿盐疾病分会. 维生素D及其类似物临床应用共识[J]. 中华骨质疏松和骨矿盐疾病杂志, 2018, 11( 1): 1- 19. DOI: 10.3969/j.issn.1674-2591.2018.01.001.
    [20]
    QIU RQ, XIA MY, HAN YY, et al. Relationship between serum 1, 25-dihydroxyvitamin D3 with CMVI and prognosis in neonates[J]. Chongqing Med, 2021, 50( 10): 1729- 1732, 1736. DOI: 10.3969/j.issn.1671-8348.2021.10.025.

    邱锐琴, 夏明月, 韩雁雁, 等. 新生儿1, 25-二羟基维生素D3与CMVI及预后的关系[J]. 重庆医学, 2021, 50( 10): 1729- 1732, 1736. DOI: 10.3969/j.issn.1671-8348.2021.10.025.
    [21]
    OKANO Y, OHURA T, SAKAMOTO O, et al. Current treatment for citrin deficiency during NICCD and adaptation/compensation stages: Strategy to prevent CTLN2[J]. Mol Genet Metab, 2019, 127( 3): 175- 183. DOI: 10.1016/j.ymgme.2019.06.004.
    [22]
    CONSIGLIO M, VIANO M, CASARIN S, et al. Mitochondrial and lipogenic effects of vitamin D on differentiating and proliferating human keratinocytes[J]. Exp Dermatol, 2015, 24( 10): 748- 753. DOI: 10.1111/exd.12761.
    [23]
    RYAN ZC, CRAIG TA, FOLMES CD, et al. 1α, 25-dihydroxyvitamin D3 regulates mitochondrial oxygen consumption and dynamics in human skeletal muscle cells[J]. J Biol Chem, 2016, 291( 3): 1514- 1528. DOI: 10.1074/jbc.M115.684399.
    [24]
    DING CL, CHEN YJ. Research advances of vitamin D in postoperative management of Kasai operation in children with biliary atresia[J]. Chin J Pediatr Surg, 2021, 42( 6): 563- 567. DOI: 10.3760/cma.j.cn421158-20200215-00073.

    丁彩琳, 陈亚军. 维生素D在胆道闭锁患儿Kasai术后治疗中应用的研究进展[J]. 中华小儿外科杂志, 2021, 42( 6): 563- 567. DOI: 10.3760/cma.j.cn421158-20200215-00073.
    [25]
    ZHUANG PJ, SUN S, DONG R, et al. Associations between vitamin D and liver function and liver fibrosis in patients with biliary atresia[J]. Gastroenterol Res Pract, 2019, 2019: 4621372. DOI: 10.1155/2019/4621372.
    [26]
    NG J, PAUL A, WRIGHT N, et al. Vitamin D levels in infants with biliary atresia: Pre- and post-kasai portoenterostomy[J]. J Pediatr Gastroenterol Nutr, 2016, 62( 5): 746- 750. DOI: 10.1097/MPG.0000000000001074.
    [27]
    DONG R, SUN S, LIU XZ, et al. Fat-soluble vitamin deficiency in pediatric patients with biliary atresia[J]. Gastroenterol Res Pract, 2017, 2017: 7496860. DOI: 10.1155/2017/7496860.
    [28]
    ABDEL-RAHMAN N, SHARAWY MH, MEGAHED N, et al. Vitamin D3 abates BDL-induced cholestasis and fibrosis in rats via regulating Hedgehog pathway[J]. Toxicol Appl Pharmacol, 2019, 380: 114697. DOI: 10.1016/j.taap.2019.114697.
    [29]
    LI J, XIA J, WU J. Correlation of the levels of fat-soluble vitamins with biochemical parameters in infants with cholestatic liver disease[J]. J Clin Hepatol, 2021, 37( 10): 2376- 2379. DOI: 10.3969/j.issn.1001-5256.2021.10.023.

    李婧, 夏婧, 吴捷. 脂溶性维生素水平与胆汁淤积性肝病患儿生化指标的相关性分析[J]. 临床肝胆病杂志, 2021, 37( 10): 2376- 2379. DOI: 10.3969/j.issn.1001-5256.2021.10.023.
    [30]
    MALHAM M, JØRGENSEN SP, OTT P, et al. Vitamin D deficiency in cirrhosis relates to liver dysfunction rather than aetiology[J]. World J Gastroenterol, 2011, 17( 7): 922- 925. DOI: 10.3748/wjg.v17.i7.922.
    [31]
    KEANE JT, ELANGOVAN H, STOKES RA, et al. Vitamin D and the liver-correlation or cause?[J]. Nutrients, 2018, 10( 4): 496. DOI: 10.3390/nu10040496.
    [32]
    MEGAHED A, GADALLA H, ABDELHAMID FM, et al. Vitamin D ameliorates the hepatic oxidative damage and fibrotic effect caused by thioacetamide in rats[J]. Biomedicines, 2023, 11( 2): 424. DOI: 10.3390/biomedicines11020424.
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