Prevalence and Associated Factors of Vertebral Fractures in Children with Chronic Liver Disease with and without Liver Transplantation.

IF 1.3 Q3 PEDIATRICS

Pediatric Gastroenterology, Hepatology & Nutrition Pub Date : 2024-05-01 Epub Date: 2024-05-07 DOI:10.5223/pghn.2024.27.3.158

Wittayathorn Pornsiripratharn, Suporn Treepongkaruna, Phatthawit Tangkittithaworn, Niyata Chitrapaz, Chatmanee Lertudomphonwanit, Songpon Getsuwan, Pornthep Tanpowpong, Pat Mahachoklertwattana

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引用次数: 0

Abstract

Purpose: To evaluate the prevalence of vertebral fracture (VF) in children with chronic liver disease (CLD) with and without liver transplantation (LT) and to determine the associated factors.

Methods: A cross-sectional study was conducted. Patients aged 3-21 years with CLD both before and after LT were enrolled in the study. Lateral thoracolumbar spine radiographs were obtained and assessed for VF using Mäkitie's method. Clinical and biochemical data were collected.

Results: We enrolled 147 patients (80 females; median age 8.8 years [interquartile range 6.0-11.8]; 110 [74.8%] in the LT group and 37 [25.2%] in the non-LT group). VF was identified in 21 patients (14.3%): 17/110 (15.5%) in the LT group and 4/37 (10.8%) in the non-LT group (p=0.54). Back pain was noted in only three patients with VF. In the univariate analysis, a height z-score below -2.0 (p=0.010), pre-LT hepatopulmonary syndrome (p=0.014), elevated serum direct and total bilirubin levels (p=0.037 and p=0.049, respectively), and vitamin D deficiency at 1-year post-LT (p=0.048) were associated with VF in the LT group. In multivariate analysis, height z-score below -2.0 was the only significant associated factor (odds ratio, 5.94; 95% confidence interval, 1.49-23.76; p=0.012) for VF. All VFs in the non-LT group were reported in males.

Conclusion: In children with CLD, VF is common before and after LT. Most patients with VF are asymptomatic. Screening for VF should be considered in patients with a height z-score below -2.0 after LT.

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接受或未接受肝移植的慢性肝病患儿椎体骨折的发生率及相关因素。

目的：评估接受或未接受肝移植（LT）的慢性肝病（CLD）患儿椎体骨折（VF）的发生率，并确定相关因素：方法：进行了一项横断面研究。方法：这是一项横断面研究，研究对象为接受肝移植前后的 3-21 岁慢性肝病患者。研究人员拍摄了胸腰椎侧位X光片，并采用Mäkitie方法对VF进行了评估。研究还收集了临床和生化数据：我们共招募了 147 名患者（80 名女性；中位年龄为 8.8 岁[四分位间差为 6.0-11.8 岁]；LT 组 110 人[74.8%]，非 LT 组 37 人[25.2%]）。21名患者（14.3%）发现了室颤：LT组为17/110（15.5%），非LT组为4/37（10.8%）（P=0.54）。只有三名 VF 患者出现背痛。在单变量分析中，身高 Z 值低于-2.0（p=0.010）、LT 前肝肺综合征（p=0.014）、血清直接胆红素和总胆红素水平升高（分别为 p=0.037 和 p=0.049）、LT 后 1 年维生素 D 缺乏（p=0.048）与 LT 组 VF 相关。在多变量分析中，身高 Z 值低于-2.0 是 VF 唯一显著的相关因素（几率比，5.94；95% 置信区间，1.49-23.76；p=0.012）。非LT组的所有VF均为男性：结论：在CLD患儿中，VF在LT前后都很常见。结论：在 CLD 儿童中，室颤在 LT 前后都很常见，大多数室颤患者都没有症状。LT后身高Z值低于-2.0的患者应考虑进行VF筛查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Gastroenterology, Hepatology & Nutrition PEDIATRICS-

CiteScore

3.90

自引率

0.00%

发文量

期刊介绍： Pediatric Gastroenterology, Hepatology and Nutrition (Pediatr Gastroenterol Hepatol Nutr), an official journal of The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, is issued bimonthly and published in English. The aim of Pediatr Gastroenterol Hepatol Nutr is to advance scientific knowledge and promote child healthcare by publishing high-quality empirical and theoretical studies and providing a recently updated knowledge to those practitioners and scholars in the field of pediatric gastroenterology, hepatology and nutrition. Pediatr Gastroenterol Hepatol Nutr publishes review articles, original articles, and case reports. All of the submitted papers are peer-reviewed. The journal covers basic and clinical researches on molecular and cellular biology, pathophysiology, epidemiology, diagnosis, and treatment of all aspects of pediatric gastrointestinal diseases and nutritional health problems.