{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T22:29:08Z","timestamp":1791325748867,"version":"4.3.1"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":3622,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:sec>\n            <jats:title>Abstract<\/jats:title>\n            <jats:p>\n                                 <jats:bold>Malabsorption of fat-soluble vitamins is a major complication of chronic cholestatic liver disease. The most accurate way to assess vitamin A status in children who have cholestasis is unknown. The goal of this study was to assess the accuracy of noninvasive tests to detect vitamin A deficiency. Children with chronic cholestatic liver disease (n = 23) and noncholestatic liver disease (n = 10) were studied. Ten cholestatic patients were identified as vitamin A\u2013deficient based on the relative dose response (RDR). Compared with the RDR, the sensitivity and specificity to detect vitamin A deficiency for each test was, respectively: serum retinol, 90% and 78%; retinol-binding protein (RBP), 40% and 91%; retinol\/RBP molar ratio, 60% and 74%; conjunctival impression cytology, 44% and 48%; slit-lamp examination, 20% and 66%; tear film break-up time, 40% and 69%; and Schirmer's test, 20% and 78%. We developed a modified oral RDR via oral coadministration of d-alpha tocopheryl polyethylene glycol-1000 succinate and retinyl palmitate. This test had a sensitivity of 80% and a specificity of 100% to detect vitamin A deficiency.<\/jats:bold>\n                                 <jats:underline>In conclusion<\/jats:underline>\n                                 <jats:bold>, vitamin A deficiency is relatively common in children who have chronic cholestatic liver disease. Our data suggest that serum retinol level as an initial screen followed by confirmation with a modified oral RDR test is the most effective means of identifying vitamin A deficiency in these subjects. (Hepatology 2005;42:782\u2013792.)<\/jats:bold>\n                              <\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.20864","type":"journal-article","created":{"date-parts":[[2005,9,20]],"date-time":"2005-09-20T22:18:26Z","timestamp":1127254706000},"page":"782-792","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":64,"title":["Comparison of Indices of Vitamin A Status in Children With Chronic Liver Disease *"],"prefix":"10.1097","volume":"42","author":[{"given":"Andrew P.","family":"Feranchak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Gralla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca 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cholestasis.","volume":"5","author":"AmedeeManesme","year":"1985","journal-title":"Hepatology"},{"key":"R4-8-20250207","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1002\/hep.1840030321","article-title":"Nervous and ocular disorders in children with cholestasis and vitamin A and E deficiencies.","volume":"3","author":"Alvarez","year":"1983","journal-title":"Hepatology"},{"key":"R5-8-20250207","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/hep.1840070208","article-title":"Liver levels of vitamin A and cellular retinolbinding protein for patients with biliary atresia.","volume":"7","author":"Ong","year":"1987","journal-title":"Hepatology"},{"key":"R6-8-20250207","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1093\/ajcn\/51.4.638","article-title":"Regulation of metabolism of retinolbinding protein by vitamin A status in children with biliary atresia.","volume":"51","author":"Mourey","year":"1990","journal-title":"Am J Clin 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