Neonatal cholestasis and urinary Thiobarbituric Acid Reactive Substance (uTBARS) levels

Neonatal cholestasis (Direct bilirubin level, [DBL]>2mg/dl on day >10) was associated with increased levels of uTBARS in a group of preterm infants. Urine samples from 10 cholestatic infants (BW 1034+/-667g; GA 27.4+/-4.7wks) and 27 controls (BW 1306+/-679g; GA 29.4+/-4.1 wks) were collected on 39.4+/-35.6 days of life and frozen at -70 F for later examination. The pH adjusted sample was combined with TBA, heated, and analyzed by spectrophotometric analysis. The groups were similar with respect to Apgar scores, oxygen requirement, arterial oxygen content, and serum bilirubin levels during the first week of life. uTBARS excretion levels (ng/mg of creatinine) are shown below: Cholestasis Control Maximum DBL(mg/dl) 7.6+/-8.5 2.5+/-1.3.3* Maximum SGOT 174.1+/-200.0 45.0+/-42.7* Maximum SGPT 89.9+/-87.9 24.3+/-35.2* *p<0.05, +p=0.1 TBARS (ng/mg creatinine) 5429.9+/-4910.6 3039.7+/-2739.4+ Multiple regression analysis revealed significant relationships between DBL and oxygen requirement, maximal total serum bilirubin concentration, and birth weight. Of note, there were no relationships noted between DBL and intravenous nutrition data. uTBARS levels were not associated with any of these variables. In these infants, cholestasis was associated with abnormal liver function tests, and with a nonsignificant increase in uTBARS, products of lipid peroxidation, suggesting a role for reactive oxygen substances in liver damage.