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Changes in apolipoproteins during the acute phase of Kawasaki disease
1Department of Pediatrics, Nihon University School of Medicine, Tokyo, Japan.
Insights
Kawasaki disease disrupts lipid metabolism, showing decreased cholesterol and altered apolipoprotein levels. These changes, particularly higher apo B/TC ratios, may signal early coronary artery issues.
Area of Science:
- Cardiology
- Pediatric Rheumatology
- Biochemistry
Background:
- Kawasaki disease is a critical pediatric illness.
- Lipid metabolism disturbances are suspected in its pathogenesis.
- Coronary artery lesions are a major complication.
Purpose of the Study:
- To investigate lipid metabolism alterations in Kawasaki disease patients.
- To correlate serum lipid and apolipoprotein changes with coronary artery involvement.
Main Methods:
- Serum levels of total cholesterol (TC), HDL-C, apo A-I, apo A-II, and apo B were measured.
- Levels were analyzed during the early stages of illness.
- Patients were stratified based on the presence of coronary artery lesions.
Main Results:
- TC and HDL-C decreased in early Kawasaki disease.
- Apo A-I and A-II levels were low until week 2; Apo B decreased in week 1.
- Elevated apo B/apo A-I and apo B/TC ratios were observed in early stages.
- Patients with coronary lesions had lower TC, HDL-C, apo A-I, A-II, and B levels.
- A higher apo B/TC ratio at week 2 was linked to coronary artery lesions.
Conclusions:
- Significant disturbances in serum lipids and apolipoproteins occur during Kawasaki disease.
- Specific lipid and apolipoprotein profiles correlate with coronary artery lesion development.
- These abnormalities may indicate early coronary arteriosclerosis in affected children.
Abstract:
To determine disturbances of lipid metabolism in patients with Kawasaki disease, we investigated changes in the serum levels of apolipoproteins and serum lipids. Results were as follows. Total serum cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) decreased during the early stage of Kawasaki disease. The apo A-I and A-II levels were low until the 2nd week of illness. Apo B decreased during the 1st week of illness, but rose slightly during the 2nd and 3rd weeks. The apo B/apo A-I ratio and the apo B/TC ratio were high in the early stages of illness. The group of patients with coronary artery lesions showed low levels of TC and HDL-C, and low levels of apo A-I, A-II and B during the early stages, compared with the group without coronary artery lesions. The apo B/TC ratio was significantly higher in the patients with coronary artery lesions during the 2nd week of illness. Our findings suggest an association between changes in serum lipids and apolipoproteins and coronary artery involvement in Kawasaki disease. These abnormalities may indicate the presence of early coronary arteriosclerosis.