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Serum Lp-PLA2 Level Predicting Coronary Artery Lesions in Children with Kawasaki Disease
Xiong Zhang1, Ya-Wang Shao2, Ya-Lan Zhang3
1Department of Laboratory, First People's Hospital of Xianyang City, Xianyang, Shaanxi Province, China. 15191018996@163.com.
Insights
Lipoprotein-associated phospholipase A2 (Lp-PLA2) levels are elevated in children with Kawasaki disease (KD) and correlate with coronary artery lesions. Lp-PLA2 may aid in KD diagnosis and assessing coronary artery damage.
Area of Science:
- Pediatric Cardiology
- Inflammatory Diseases
- Biomarker Discovery
Background:
- Kawasaki disease (KD) is a critical pediatric inflammatory condition.
- Coronary vasculitis and subsequent coronary artery lesions (CAL) are significant complications of KD.
- The role of Lipoprotein-associated phospholipase A2 (Lp-PLA2) in KD pathogenesis requires further investigation.
Purpose of the Study:
- To investigate the association between serum Lp-PLA2 levels and the presence and severity of coronary artery lesions (CAL) in children diagnosed with Kawasaki disease (KD).
- To evaluate Lp-PLA2 as a potential diagnostic and prognostic biomarker for KD, particularly concerning cardiovascular complications.
Main Methods:
- Serum levels of Lp-PLA2, Interferon-γ (IFN-γ), Interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were measured in 93 KD patients and 42 controls.
- Echocardiography and color Doppler ultrasound were used to assess coronary artery diameters (LMCA, LADC, PRCA) and carotid intima-media thickness (IMT).
- Statistical analyses, including logistic regression, were performed to determine the correlation between biomarkers and CAL.
Main Results:
- KD patients exhibited significantly elevated levels of WBC, ESR, CRP, IFN-γ, IL-6, Lp-PLA2, and IMT compared to controls.
- Children with CAL showed markedly higher levels of CRP, IFN-γ, IL-6, Lp-PLA2, and IMT than those with normal coronary arteries (NCA).
- Elevated Lp-PLA2 levels were independently associated with KD and CAL, positively correlating with inflammatory markers and coronary artery diameters.
Conclusions:
- Lp-PLA2 is implicated in the pathological mechanisms underlying Kawasaki disease.
- Serum Lp-PLA2 levels serve as a valuable indicator for diagnosing KD and assessing the extent of coronary artery lesions in affected children.
Background:
Kawasaki disease (KD) is an inflammatory disease associated with coronary vasculitis in children. In this study, we explored the correlation between Lipoprotein associated phospholipase A2 (Lp-PLA2) and coronary artery lesions (CAL) in children with KD.
Methods:
Ninety-three children with KD were divided into a normal coronary artery (NCA, 54 cases) group and coronary artery lesions (CAL, 39 cases) group, according to the results of echocardiography. Another 42 healthy children were selected as the control group. The serumal levels of Lp-PLA2, Interferon-γ(IFN-γ) and Interleukin-6 (IL-6) were determined by using an enzyme-linked immunosorbent assay. In addition, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) level were analyzed. The left main coronary artery (LMCA), diameters of left anterior descending coronary artery (LADC), right proximal coronary artery (PRCA), and carotid intima-media thickness (IMT) were obtained by color Doppler ultrasound. The correlation between the above indexes and KD was analyzed.
Results:
The levels of white blood cell counts (WBC), ESR, CRP, IFN-γ, IL-6 and Lp-PLA2 as well as IMT were significantly increased in KD children (P < 0.05), and the levels of CRP, IFN-γ, IL-6 and Lp-PLA2 as well as IMT in the CAL group increased more significantly (P < 0.05). An increasing trend also has been described in the diameters of LMCA, LADC and PRCA for KD children with CAL compared with with NCA. The results of logistic regression analysis showed that the elevated levels of CRP, IFN-γ, IL-6 and Lp-PLA2 were independent risk factors for KD with CAL. Correlation analysis showed that Lp-PLA2 level was positively correlated with the levels of IFN-γ, IL-6 and CRP in CAL group and NCA group (respectively, all P < 0.01). In addition, a similar correlation was also described between Lp-PLA2 level and the diameters of LMCA, LADC and PRCA in CAL group (respectively, all P < 0.01).
Conclusion:
Lp-PLA2 may participate in the pathological mechanism of KD. Detection of the serum Lp-PLA2 level can be used in the diagnosis of KD disease and the assessment of coronary artery lesions in KD children.
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