Association Between Serum 25-hydroxy-vitamin D Level, Liver Function and Liver Fibrosis in Biliary Atresia Infants One Year After Kasai Procedure

Abstract Objective: To investigate the relationship between serum 25 (OH) D level, liver function, and liver fibrosis in infants with in biliary atresia (BA) infants one year after Kasai procedure. Methods: This retrospective study was conducted using the clinical data of children with BA confirmed by cholangiography and/or surgery admitted to Children Hospital of Shanxi Province between October 2018 and October 2020, as well as the follow-up data at 1, 3, 6, and 12 months after Kasai Portoenterotomy so as to analyze the relationship between serum 25(OH) D level, liver function, and liver fibrosis. Results: Preoperative data of 57 infants with BA were collected. All infants had vitamin D insufficiency or deficiency status before surgery. Three months after surgery, data were collected from 55 infants, 15 of whom did not take vitamin D supplements and 40 of whom received regular vitamin D supplementation. It was found that 15.38%, 47.22%, 75%, and 92.31% of infants living with regular vitamin D supplementation and native liver had sufficient vitamin D levels at 3, 6, and 12 months after Kasai surgery, respectively. The serum 25(OH) D level was significantly lower in patients without vitamin D supplements at 3 months after surgery (t=-2.974，P＜0.05), and the aspartate aminotransferase to platelet ratio index (APRI) was higher in patients with vitamin D supplementation. There was no significant correlation between vitamin D level, liver function, and liver fibrosis preoperatively (P＞0.05). The level of serum 25(OH) D was negatively correlated with liver fibrosis and liver function in infants with the native liver at 12 months after surgery (P < 0.05).Conclusion: Vitamin D deficiency was commonly found in children with BA before operation. Nearly 70% of infants living with native liver reached sufficient vitamin D levels within 6 months after surgery with routine vitamin D supplementation. Serum 25 (OH)D level can reflect the degree of liver fibrosis and liver function in biliary atresia infants living with the native liver at 12 months after the Kasai procedure.