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Blood levels of vitamin D in children and adolescents with chronic cholestasis

OBJECTIVE: to verify blood levels of vitamin D in patients with chronic cholestasis, and relate them to nutritional status, length of time since the onset of cholestasis and use of vitamin supplement. METHODS: controlled cross-sectional study with chronic cholestasis as study factor and blood levels of vitamin D as outcome. The study included patients aged between 4 months and 18 years, who were cared for at the Pediatric Gastroenterology Unit of Hospital de Clínicas de Porto Alegre. Controls were eutrophic children in the same age range. Blood was collected for radioimmunoassay. Anthropometric analyses were performed, as was determination of the length of time since the onset of cholestasis and use of vitamin supplement. RESULTS: twenty-two patients and 17 controls were evaluated. Average vitamin D level in patients was 13.7 ± 8.39 ng/ml, compared to 25.58 ± 16.73 ng/ml in controls (p = 0.007). Prevalence of hypovitaminosis D in patients was 36%. Median of period of time since the onset of cholestasis was 1 year with variation of 6 months to the 25th percentile and 3.9 years to the 75th percentile. Anthropometric evaluation (NCHS) showed 36% of malnutrition by weight and 41% by height. Anthropometric evaluation according to Z score showed 33.3% and 23.8% prevalence of malnutrition for the criteria height/age and weight/age, respectively. The evaluation of weight regarding height did not show values below two standard deviations. No relationship was found between nutritional state, use of oral vitamin supplement and blood levels of vitamin D. CONCLUSIONS: blood levels of vitamin D in patients with cholestasis were lower than those of controls, but were not related to nutritional status, period of time since the onset of cholestasis or use of vitamin supplement.

chronic cholestasis; vitamin D; malnutrition


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