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Biliary atresia (BA) is one of most common of liver disease during childhood in Japan. BA is a cicatrical obstruction of extra-hapatic biliary system in the neonatal age. This disease requires corrective surgery on the porta hepatis, following reconstruction of bile draining intestinal tube, within 2 months of age ideally. BA children develop malnourish when their jaundice is not solved without proper drainage of bile juice and with progressive advancement of liver cirrhosis. However they have elevated energy expenditures and have kept normal appetites. We retrospectively studied the energy balance, body composition, and serum hormone concentrations in 18 BA children (age ranged between 1–13 years). The patients were divided into two groups: the jaundiced group (group J), in whom the serum bilirubin level was 1.0 mg/dl; and the non-jaundiced group (group non-J), in whom the serum bilirubin level was 1.0 mg/dl. Anthropometric indices studied included height, weight, arm muscle area, and fat area as calculated by mid-upper arm circumference and triceps skin fold. An energy balance study was conducted, and serum interleukin (IL)-6 and serum leptin levels were measured. Lower adiposity, higher energy intake (overeating), higher energy expenditure, higher serum IL-6 levels, and lower serum leptin levels were found in group J compared with group non-J. To our knowledge, this is the first report correlating overeating with hypoleptinemia in pediatric BA patients with jaundice. Serum leptin levels may play a key role in eating abnormalities with persistent jaundice.

Hypoleptinemia Associated with Hypermetabolism, Low Adiposity Body Composition and Overeating Behavior in Children with Jaundiced Biliary Atresia