{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T13:56:16Z","timestamp":1791640576646,"version":"4.3.4"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Human Nutrition Diet"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infants with cholestasis are at risk of fat\u2010soluble vitamin deficiency. The present study amied to review practice relating to the assessment, deficiency and supplementation of fat\u2010soluble vitamins in infants with cholestasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The medical records of all newly diagnosed infants with cholestasis (conjugated bilirubin &gt;17\u2009mmol\u00a0L\n                      <jats:sup>\u20131<\/jats:sup>\n                      \/&gt;20% total bilirubin) at King's College Hospital between 2017 and 2019 were reviewed. Data extracted included bilirubin, serum vitamin concentrations (A, D, E), international normalised ratio and evidence of supplementation at initial assessment, as well as at 3 and 6 months. Rates of vitamin assessment, deficiency and supplementation were compared using chi\u2010squared or Fisher's exact test.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 136 infants (87 male) with idiopathic neonatal cholestasis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200962), biliary atresia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200940) and other aetiology (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934) were included. Assessment of serum vitamins (A, D, E) was low (33.3%\u201352.2%) and deficiency was initially high for vitamin D (60.6%) and vitamin E (70.9%). Supplementation prevalence at initial assessment was high (A, E, K), but dropped significantly at 3 and 6 months for vitamin E (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and vitamin K (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), whereas vitamin D supplementation was consistently low throughout (25%\u201333.3%). Infants with biliary atresia were more likely to have vitamins assessed (3 months), be deficient initially (D, E) and supplemented (E, K) throughout. Supplementation continued in up to 80% of infants despite cholestasis resolving.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Supplementation was generally high and continued in many despite cholestasis resolving. Deficiency of vitamin D and vitamin E was high at initial assessment, although lower at follow\u2010up. Actual prevalence of deficiency of all vitamins is unknown because monitoring was not consistently performed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jhn.12957","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T12:47:21Z","timestamp":1634906841000},"page":"273-279","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Fat\u2010soluble vitamin assessment, deficiency and supplementation in infants with cholestasis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6811-3461","authenticated-orcid":false,"given":"Sara","family":"Mancell","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maeisha","family":"Islam","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics King's College Hospital NHS Foundation Trust  London UK"},{"name":"Department of Nutritional Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Dhawan","sequence":"additional","affiliation":[{"name":"Paediatric Liver, GI &amp; Nutrition Centre King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-2950","authenticated-orcid":false,"given":"Kevin","family":"Whelan","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001334"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001467"},{"key":"e_1_2_11_4_1","first-page":"83","article-title":"The infant with prolonged jaundice: investigation and management","volume":"11","author":"McKiernan P","year":"2001","journal-title":"Paediatr Child Health"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-1423"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s003830100003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e31819a61ff"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000001331"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000002443"},{"key":"e_1_2_11_10_1","unstructured":"National Institute for Health and Care Excellence (NICE) Vitamin D deficiency in children.https:\/\/cks.nice.org.uk\/topics\/vitamin-d-deficiency-in-children\/(2020). 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