Journal of pediatric surgery · 2026
Risk factors for postoperative growth retardation in children with biliary atresia after Kasai portoenterostomy: A retrospective analysis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Tan Xinyue, Li Guantong, Liu Xuming, Wang Dingding, Zhao Yong, Zhang Yanan, Sun Dayan, Li Shuangshuang, Hua Kaiyun, Gu Yichao, Liao Junmin, Huang Jinshi
Аннотация
OBJECTIVE: This study aimed to evaluate the growth and development status of children with biliary atresia (BA) following Kasai portoenterostomy (KPE) and identify the risk factors associated with postoperative growth retardation (GR).
METHODS: A retrospective-observational study was conducted on 88 BA patients who underwent KPE at a single center between March 2016 and October 2024. Growth was assessed using Z-scores with GR defined as weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ) or BMI-for-age Z-Score (BAZ) < -2SD at final follow-up. Clinical and biochemical variables were compared between GR and non-GR groups. Logistic regression with LASSO feature selection was used to explore variables associated with GR.
RESULTS: The prevalence of GR was 15.9% (14/88) in the overall cohort and 17.7% (11/62) in native-liver survivors. GR was more common in children aged <2.5 years and >7.5 years. Lower weight at surgery, preoperative very low-density lipoprotein (VLDL), creatinine (Cr) and Prealbumin (PA), as well as early postoperative VLDL and Lactate dehydrogenase (LDH) levels were associated with GR. Early postoperative higher VLDL levels were the sole variable retained in the exploratory LASSO model (OR = 3.769, 95% CI: 1.608-11.199, p < 0.05), with an optimal cut-off value of 0.45 mmol/L. Dynamic biochemical analysis revealed distinct metabolic profiles in the GR group, including creatine kinase (CK), uric acid (UA) and albumin (ALB) postoperatively.
CONCLUSION: Early postoperative higher VLDL levels were associated with GR in BA patients and with reduced muscle-related markers, suggesting a distinct metabolic profile. Monitoring early postoperative VLDL may help identify children who could benefit from earlier nutritional assessment.
METHODS: A retrospective-observational study was conducted on 88 BA patients who underwent KPE at a single center between March 2016 and October 2024. Growth was assessed using Z-scores with GR defined as weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ) or BMI-for-age Z-Score (BAZ) < -2SD at final follow-up. Clinical and biochemical variables were compared between GR and non-GR groups. Logistic regression with LASSO feature selection was used to explore variables associated with GR.
RESULTS: The prevalence of GR was 15.9% (14/88) in the overall cohort and 17.7% (11/62) in native-liver survivors. GR was more common in children aged <2.5 years and >7.5 years. Lower weight at surgery, preoperative very low-density lipoprotein (VLDL), creatinine (Cr) and Prealbumin (PA), as well as early postoperative VLDL and Lactate dehydrogenase (LDH) levels were associated with GR. Early postoperative higher VLDL levels were the sole variable retained in the exploratory LASSO model (OR = 3.769, 95% CI: 1.608-11.199, p < 0.05), with an optimal cut-off value of 0.45 mmol/L. Dynamic biochemical analysis revealed distinct metabolic profiles in the GR group, including creatine kinase (CK), uric acid (UA) and albumin (ALB) postoperatively.
CONCLUSION: Early postoperative higher VLDL levels were associated with GR in BA patients and with reduced muscle-related markers, suggesting a distinct metabolic profile. Monitoring early postoperative VLDL may help identify children who could benefit from earlier nutritional assessment.