Increased concentrations of growth differentiation factor-15 in children with Kawasaki disease
Insights
Serum growth differentiation factor-15 (GDF-15) is elevated in children with Kawasaki disease (KD), particularly those with coronary artery lesions (CALs) or non-response to treatment. GDF-15 predicts CALs and treatment outcomes in KD.
Area of Science:
- Pediatrics
- Immunology
- Biochemistry
Background:
- Kawasaki disease (KD) is an acute febrile illness affecting young children.
- Coronary artery lesions (CALs) are a significant complication of KD.
- Predicting CALs and treatment response in KD remains crucial.
Purpose of the Study:
- To investigate serum growth differentiation factor-15 (GDF-15) levels in children with acute KD.
- To evaluate GDF-15's role in predicting CALs and non-response to intravenous immunoglobulin (IVIG) therapy.
- To compare GDF-15's predictive performance against established inflammatory markers.
Main Methods:
- Serum samples were collected from 131 children with KD and 30 healthy controls before IVIG.
- Serum GDF-15 concentrations were quantified using ELISA kits.
- Univariate and multivariate logistic regression analyses were performed to assess associations with CALs and treatment response.
Main Results:
- Serum GDF-15 levels were significantly higher in KD patients compared to healthy controls.
- Elevated GDF-15 was observed in KD patients with CALs versus those without, and in non-responders versus responders.
- GDF-15 showed positive correlations with white blood cell count, CRP, and ESR, and negative associations with albumin and pre-albumin.
- GDF-15 independently predicted CALs and non-response to IVIG, outperforming CRP and ESR individually for CAL prediction.
Conclusions:
- Serum GDF-15 concentrations are significantly elevated in acute KD, especially in cases with CALs and non-response to treatment.
- GDF-15 serves as a valuable independent predictor for the development of CALs and treatment non-response in KD.
- GDF-15 demonstrates potential as a superior or non-inferior biomarker for predicting CALs in KD compared to CRP and ESR.
Background:
We investigated the serum concentrations of growth differentiation factor-15 (GDF-15) in children with acute Kawasaki disease (KD) and evaluate its role in predicting coronary artery lesions (CALs) and no response KD.
Methods:
We obtained blood sample from 30 healthy children and 131 children with KD before intravenous immunoglobulin therapy. Serum GDF-15 concentrations were measured using ELISA kits. Univariate and multivariate logistic regression analysis were conducted to evaluate the potential association between GDF-15 and the occurrence of CALs and treatment responses.
Results:
Serum GDF-15 concentrations in KD were remarkably increased compared with healthy control. Serum GDF-15 concentrations in KD with CALs were also increased compared with no CALs, and in no response KD compared with response KD. Serum of GDF-15 concentrations was positively correlated with white blood cell count, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and negatively associated with albumin and pre-albumin in all patients with KD. GDF-15 was an independent predictor of CALs and no response KD. GDF-15 was superior to CRP and ESR, while it was not inferior to the combination of CRP and ESR for predicting CALs.
Conclusions:
Serum of GDF-15 concentrations was significantly increased in acute KD patients, especially in KD with CALs and no response KD. GDF-15 could sever as an independent predictor for CALs and no response KD.
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