{
  "abstract": "Background\n\nSerum 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.Methods\n\nExploratory 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 (n = 15), non-cholestatic (n = 45) and post-transplant (n = 6) groups were compared.Results\n\nVitamin 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%; p = 0.030). E:TG was inversely correlated with 25(OH)D (rho = -0.45; p < 0.001).Conclusions\n\nLipid-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.",
  "abstract_shown": true,
  "affiliations": [
    "\"Iuliu Haţieganu\" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.",
    "2nd Pediatric Discipline, Department of Mother and Child, Faculty of Medicine, \"Iuliu Haţieganu\" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.",
    "2nd Pediatric Clinic, Emergency Clinical Hospital for Children, 400124 Cluj-Napoca, Romania.",
    "HIVE Health Innovation Center, Babeș-Bolyai University, 400095 Cluj-Napoca, Romania."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Sorina Adam",
      "orcid": "0000-0002-2074-0714"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Alina Grama"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Alexandra Mititelu",
      "orcid": "0000-0002-0955-4486"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Gabriel Bența",
      "orcid": "0000-0002-2099-8379"
    },
    {
      "affs": [
        3
      ],
      "name": "Răzvan M Cherecheș"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Tudor Lucian Pop",
      "orcid": "0000-0002-4931-1219"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/77qewzh5r91a2.bib",
  "cited_by": 0,
  "doi": "10.3390/nu18193283",
  "fulltext_url": "https://europepmc.org/articles/PMC13666619",
  "id": "77qewzh5r91a2",
  "issns": [
    "2072-6643"
  ],
  "landing_url": "https://europepmc.org/article/MED/42884734",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2704|Antioxidant Activity and Oxidative Stress"
    ]
  ],
  "openalex": "W7220723527",
  "pdf_url": "https://europepmc.org/articles/PMC13666619?pdf=render",
  "pmcid": "PMC13666619",
  "pmid": "42884734",
  "published": "2026-10-06",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/77qewzh5r91a2.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:00Z",
      "native_id": "MED:42884734",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42884734"
    },
    {
      "first_seen": "2026-10-30T12:19:56Z",
      "native_id": "10.3390/nu18193283",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6643/18/19/3283"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2072-6643",
      "subfield": "nutrition"
    }
  ],
  "title": "Lipid-Adjusted Vitamin E Status in Children with Chronic Liver Disease: Reclassification Patterns and Differences According to Cholestasis and Liver Transplantation.",
  "title_text": "Lipid-Adjusted Vitamin E Status in Children with Chronic Liver Disease: Reclassification Patterns and Differences According to Cholestasis and Liver Transplantation.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:56Z",
  "url": "https://research.draconitic.com/paper/77qewzh5r91a2",
  "venue": "Nutrients",
  "versions": []
}