Bone mineral density, 25-hydroxyvitamin d levels and chronic liver disease in pediatric patients
International Journal of Development Research
Bone mineral density, 25-hydroxyvitamin d levels and chronic liver disease in pediatric patients
Received 17th October, 2019; Received in revised form 03rd November, 2019; Accepted 06th December, 2019; Published online 31st January, 2020
Copyright © 2020, Ionar Figueredo Bonfim Rezendea et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Bone health of children and adolescents has been the focus of studies in recent years, since it is necessary to understand the low bone mass and / or hypovitaminosis D in pediatric patients with chronic disease, in order to propose a preventive and therapeutic strategy for promote healthy skeletal growth. This study sought to describe bone mineral density (BMD) and serum vitamin D levels in pediatric patients, followed up at referral outpatient clinics for liver disease. This is a descriptive study with patients aged 5-19 years, seen at outpatients with liver disease. Variables studied: body mass index, sexual maturation stage, serum levels of 25-hydroxyvitamin D and BMD by dual emission X-ray absorptiometry. Hypovitaminosis D values <20 ng / ml and low BMD were considered, Z scores ≤ -2 standard deviations. The patients were divided into two groups: one with chronic liver disease under conservative treatment and the other with transplant patients. The data were analyzed using the tests: Student's t, Mann-Whitney, Pearson's chi-square, Fisher's exact test and logistic regression analysis. P <0.05 were considered significant. Were studied 132 patients, 98 (74.2%) under conservative treatment and 34 (25.8%) transplanted. Comparing the two groups, it was observed that those undergoing clinical treatment were older [12.4 (3.5) vs 10.5 (3.1); p = 0.007], had a greater severity of the disease (27.6% vs 5.9%; p = 0.009) and a higher percentage of patients with low BMD (23.5% vs 2.9%; p = 0.007). In the conservative treatment group, those with low BMD had a higher frequency of hypovitaminosis D when compared to those with normal BMD (56.5% vs 29.7%; p = 0.019), even after adjusting for the severity of the disease (p = 0.038). Patients under conservative treatment had a lower BMD when compared to those undergoing liver transplantation and when analyzed separately, in the first group an association was observed between BMD and serum vitamin D levels.
