ArticleNutrients2026
Lipid-Adjusted Vitamin E Status in Children with Chronic Liver Disease: Reclassification Patterns and Differences According to Cholestasis and Liver Transplantation.
Article in Nutrients, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSerum α-tocopherol depends on lipids, so absolute concentrations misclassify vitamin E status in children with chronic liver disease (CLD). The CALIPER program defined lipid-adjusted E:cholesterol (E:C) and E:triglyceride (E:TG) ratios, but their application in mixed-etiology pediatric CLD using immunoassay has not been reported.
methodsExploratory single-center cross-sectional study of 66 children (observed age range 4 months-17.9 years) with mixed-etiology CLD. Retinol and total vitamin E were measured by ELISA, whereas the CALIPER reference intervals applied here were established for α-tocopherol measured by HPLC; the two platforms are not interchangeable, so every classification reported is an exploratory application of those cutoffs. Vitamin E status was classified by absolute concentration, E:C (<3.7) and E:TG (<8.5). Cholestatic (
resultsVitamin A was largely preserved (5.2% below WHO). Vitamin E was low in 45.3% by absolute concentration, 62.5% by E:C and 43.8% by E:TG. Of 35 children with a normal absolute vitamin E concentration, 11 (31.4%) were reclassified as low by E:C. Low E:C differed across groups (cholestatic 78.6%, non-cholestatic 63.6%, post-transplant 16.7%;
conclusionsLipid-adjusted interpretation reclassified a substantial proportion of children whose absolute vitamin E concentration appeared adequate, and the prevalence of a low E:C ratio was lower among post-transplant participants than in the other two groups. In this exploratory cohort, the E:C ratio showed greater potential than the E:TG ratio for lipid-adjusted interpretation of vitamin E status; prospective validation against HPLC-based measurements and established functional indices is required before routine clinical adoption.
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