Abstract
Background Kawasaki disease (KD) is a self-limited vasculitis with unknown etiologies, and coronary artery lesions (CALs) are the most common and serious complications. Retinol-binding protein 4 (RBP4) has been confirmed effects on vasodilation, platelet activation inhibition, and cardiovascular diseases by researches. Therefore, this study was aimed at investigating the relationship between RBP4 and inflammation as well as thrombogenesis in children with KD. Methods 79 subjects were from 62 children with KD and 17 healthy controls (HCs). The KD group was divided into KD with CALs (KD-CALs) and KD without CALs (KD-NCALs), and the serum RBP4 levels were measured by enzyme-linked immunosorbent assay (ELISA). Results Compared with the HC group, serum RBP4 levels in the KD group were significantly decreased (p < 0.05). RBP4, hemoglobin (Hb), and mean platelet volume (MPV) levels were higher, while platelet counts (Plt) and thrombin time (TT) levels were lower in the KD-NCALs group than in the KD-CALs group (p < 0.05). RBP4 had positive correlation with time point of intravenous immunoglobulin (IVIG), Hb, and percentage of leukomonocytes (L%) and negative correlation with the percentage of neutrophils (N%), MPV, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), prothrombin time (PT), fibrinogen (Fbg), and D-dimer (DD) in the KD group; RBP4 had positive correlation with the time point of IVIG and L% and negative correlation with N%, MPV, and NLR in the KD-NCALs group; and RBP4 had positive correlation with Hb and L% and negative correlation with N%, CRP, NLR, and PT in the KD-CALs group (p < 0.05). Multiple linear regression analysis confirmed that Hb and CRP in the KD group, MPV and N% in the KD-NCALs group, and PT and CRP in the KD-CALs group were independent predictors of RBP4 (p < 0.05). Conclusion Lower RBP4 was observed in the KD group than in the HC group, and RBP4 had associations with markers of inflammation and thrombogenesis in children with KD.
Highlights
Kawasaki disease (KD) is a vasculitis of small and medium vessels and mainly affects young children under 3 years old, and the exact etiology of KD is still unclear
White blood cell counts (WBC), platelet counts (Plt), hemoglobin (Hb), percentage of neutrophils (N%), percentage of leukomonocytes (L%), mean platelet volume (MPV), and platelet distribution width (PDW) were assessed by a Sysmex XE-2100 hematology analyzer (Sysmex, Japan); C-reactive protein (CRP) was assessed by a gold standard digital quantitative analyzer (UPPER, China); ESR was assessed by a VISION automatic dynamic erythrocyte sedimentation rate analyzer (YHLO, China); Pct was assessed by a Roche Cobas 8000 automatic electrochemiluminescence immunoassay analyzer (Roche, Germany); aspartate aminotransferase (AST), alanine aminotransferase (ALT), and creatine kinase-MB (CK-MB) were assessed by a Vitros-350 automatic dry biochemical analyzer (Johnson& Johnson, USA); and prothrombin time (PT), activated partial thromboplastin time (APTT), Fbg, thrombin time (TT), and DD were assessed by a Sysmex CS 5100 automatic blood coagulation analyzer (Sysmex, Japan)
The levels of Retinol-binding protein 4 (RBP4), Hb, and MPV were higher in the KD-NCALs group than in the KD-coronary artery lesions (CALs) group (p < 0:05)
Summary
Kawasaki disease (KD) is a vasculitis of small and medium vessels and mainly affects young children under 3 years old, and the exact etiology of KD is still unclear. Coronary artery lesions (CALs), thrombogenesis [1, 2], and even myocardium infarction are the most serious complications in children with KD, and so KD has been taken as the main cause of children with acquired heart diseases now. Kawasaki disease (KD) is a self-limited vasculitis with unknown etiologies, and coronary artery lesions (CALs) are the most common and serious complications. RBP4, hemoglobin (Hb), and mean platelet volume (MPV) levels were higher, while platelet counts (Plt) and thrombin time (TT) levels were lower in the KD-NCALs group than in the KD-CALs group (p < 0:05). Lower RBP4 was observed in the KD group than in the HC group, and RBP4 had associations with markers of inflammation and thrombogenesis in children with KD
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