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Lipoprotein particle concentrations in children and adults following Kawasaki disease
Jonathan Lin1, Sonia Jain2, Xiaoying Sun2
1Department of Pediatrics, University of California, San Diego, La Jolla, CA; Rady Children's Hospital San Diego, San Diego, CA.
Insights
Children and adults with a history of Kawasaki disease (KD) do not show increased atherosclerosis risk. Lipoprotein particle analysis revealed no higher risk lipid patterns compared to healthy controls.
Area of Science:
- Cardiovascular Medicine
- Pediatric Cardiology
- Lipid Metabolism
Background:
- Kawasaki disease (KD) is an acute febrile illness affecting young children.
- KD can lead to coronary artery aneurysms and increased long-term cardiovascular risk.
- Lipoprotein particle profiles are key indicators of atherosclerosis risk.
Purpose of the Study:
- To evaluate lipoprotein particle profiles in pediatric and adult KD survivors.
- To determine if KD history is associated with lipid patterns indicative of future atherosclerosis risk.
Main Methods:
- Nuclear magnetic resonance spectroscopy was used to measure lipoprotein particle concentrations and sizes.
- Fasting serum samples were analyzed from 192 children and 63 adults with KD history and 90 healthy controls.
- Data were analyzed using a least-square means model with adjustments for age and sex.
Main Results:
- Both pediatric and adult KD groups had lower very low-density lipoprotein-chylomicron particles, intermediate-density lipoproteins, triglycerides, and total cholesterol (TC) compared to controls.
- Pediatric KD subjects showed lower LDL particle and LDL cholesterol concentrations.
- Adult KD subjects had lower HDL particle and HDL-C concentrations, though HDL-C remained within normal ranges.
Conclusions:
- Lipoprotein particle analysis indicates that KD survivors (pediatric and adult) do not exhibit lipid patterns associated with increased atherosclerosis risk.
- These findings suggest that KD history, irrespective of aneurysm status, does not confer a higher risk for atherosclerosis based on lipid profiles.
Objective:
To test the hypothesis that children and adults with a history of Kawasaki disease (KD) are more likely to have abnormal lipoprotein particle profiles that could place them at increased risk for developing atherosclerosis later in life.
Study Design:
Fasting serum samples were obtained from 192 children and 63 adults with history of KD and 90 age-similar healthy controls. Lipoprotein particle concentrations and sizes were measured by nuclear magnetic resonance spectroscopy (LipoScience Inc, Raleigh, North Carolina), and serum was assayed for total cholesterol (TC), triglycerides, and high-density lipoprotein (HDL) cholesterol (HDL-C). Low-density lipoprotein (LDL) cholesterol was estimated using the Friedewald formula. Data were analyzed in a least-square means model, with adjustment for age and sex and with the use of Holm correction for multiple comparisons.
Results:
Compared with respective control groups, both adult and pediatric subjects with KD had significantly lower mean very low-density lipoprotein-chylomicron particles, intermediate-density lipoproteins, triglycerides, and TC concentrations. Pediatric subjects with KD had significantly lower LDL particle and LDL cholesterol concentrations and lower mean TC/HDL-C ratio (P < .001). In contrast, the adult subjects with KD had significantly lower HDL particle, small HDL particle, and HDL-C concentrations (P < .001), but HDL-C was within normal range.
Conclusions:
Nuclear magnetic resonance lipoprotein particle analysis suggests that pediatric and adult subjects with KD, regardless of their aneurysm status, are no more likely than age-similar, healthy controls to have lipid patterns associated with increased risk of atherosclerosis.
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