Key result
Serum Lp-PLA2 levels were significantly higher in Kawasaki disease patients with coronary artery aneurysms compared to those without (median 5.56 vs 4.64 µg/mL, p<0.001), and showed moderate diagnostic potential for predicting aneurysms.
Why the study?
Coronary artery lesions including aneurysm are the most severe complications of Kawasaki disease, and Lp-PLA2 is implicated in inflammation and lipid metabolism, which are involved in Kawasaki disease development.
Does serum Lp-PLA2 level predict Kawasaki disease and the occurrence of coronary artery aneurysms in children?
Observational (n=185)
No
Does serum Lp-PLA2 level predict Kawasaki disease and the occurrence of coronary artery aneurysms in children?
Serum Lp-PLA2 levels are significantly elevated in children with Kawasaki disease, particularly those with coronary artery aneurysms, suggesting its potential as a diagnostic and predictive biomarker.
Lp-PLA2 may aid aneurysm risk stratification in Kawasaki disease; hypothesis-generating and requires prospective validation before clinical use.
Background Coronary artery lesions including aneurysm, as the most severe complications of Kawasaki disease (KD), remain of great concern. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is implicated in the regulation of inflammatory response and lipid metabolism. Since excessive inflammatory response and aberrant lipid metabolism have involved in the development of KD, we in this study sought to investigate the relationship between coronary artery aneurysm (CAA) and Lp-PLA2 and other blood parameters in children with KD. Methods The participants included 71 KD patients, 63 healthy controls (HCs) and 51 febrile controls (FCs). KD patients were divided into KD-CAA (KD with CAA) group and KD-NCAA (KD without CAA) group. Serum Lp-PLA2 levels were measured using enzyme-linked immunosorbent assays. Other routine clinical parameters were also detected. Results Serum Lp-PLA2 levels in KD group [4.83 μg/mL (3.95–6.77)] were significantly higher than those in HC [1.29 μg/mL (0.95–2.05)] and FC [1.74 μg/mL (1.18–2.74)] groups. KD-CAA group [5.56 μg/mL (4.55–22.01)] presented substantially higher serum Lp-PLA2 levels as compared with KD-NCAA group [4.64 μg/mL (2.60–5.55)]. In KD group, serum Lp-PLA2 level was positively related with erythrocyte sedimentation rate, the levels of leukocytes, platelets, albumin, creatine kinase-MB, and D-dimer, and the Z- scores of left main CA, right CA, left anterior descending CA, and left circumflex CA; and negatively related with mean corpuscular hemoglobin concentration and mean platelet volume. Moreover, receiver operating characteristic curves showed that Lp-PLA2 exhibited superior and moderate diagnostic performance for distinguishing KD patients from HC and FC ones, respectively, and possessed the potential ability to predict the occurrence of CAAs in KD. Conclusion Lp-PLA2 may be related to KD and the formation of CAAs, and thus may serve as a potential diagnostic biomarker for KD.
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Cheng et al. (2022) conducted an observational in Kawasaki Disease (n=185). Serum Lipoprotein-associated phospholipase A2 (Lp-PLA2) levels vs. Healthy controls, febrile controls, or Kawasaki disease patients without coronary artery aneurysms was evaluated on Serum Lp-PLA2 levels in Kawasaki disease patients with coronary artery aneurysms (KD-CAA) versus those without (KD-NCAA) (p=<0.001). Serum Lp-PLA2 levels were significantly higher in Kawasaki disease patients with coronary artery aneurysms compared to those without (median 5.56 vs 4.64 µg/mL, p<0.001), and showed moderate diagnostic potential for predicting aneurysms.
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