Department of Pediatrics and Adolescent Medicine, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
Korean Circ J. 2010 Mar;40(3):137-40. doi: 10.4070/kcj.2010.40.3.137. Epub 2010 Mar 24.
Kawasaki disease (KD) is an acute systemic vasculitis in children which causes coronary arterial dilatation (CAD) and gallbladder distension (GBD). There is a dearth of investigating the relationship between the severity of KD and GBD with lipid profiles.
A total of 80 patients with 'complete KD' who were diagnosed from January 2005 to May 2009 was enrolled in this study. Serum cholesterol {total, high density lipoprotein-cholesterol (HDL-C) and low density lipoprotein-cholesterol (LDL-C)}, triglyceride (TG), complete blood count, inflammation markers {erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)} were measured at the time of admission during febrile period. Echocardiography and abdominal sonogram were performed in all patients to determine CAD and gallbladder size. According to GBD, patients with KD were classified as patients with GBD and patients without GBD. Between two groups, demographic and clinical data were analyzed.
The serum level of LDL-C was significantly lower in patients with GBD (p=0.03) compared with patients without GBD or febrile control. There was no significant difference in inflammatory indices between patients with GBD and patients without GBD. GBD was not significant risk factor of CAD in this study (odds ratio=2.0, 95% confidence interval=0.82-5.3, p=0.16).
This is the first study that highlights the relationship between the GBD and lipid metabolism in patients with KD. This study provides clinical insights about potential mechanism underpinning the relationship between the GBD and lipid metabolism.
川崎病(KD)是一种儿童急性全身性血管炎,可导致冠状动脉扩张(CAD)和胆囊扩张(GBD)。目前,关于 KD 的严重程度与 GBD 与血脂谱之间的关系的研究还很少。
本研究共纳入 2005 年 1 月至 2009 年 5 月期间诊断为“完全 KD”的 80 例患者。在发热期入院时,测量血清胆固醇(总胆固醇、高密度脂蛋白胆固醇[HDL-C]和低密度脂蛋白胆固醇[LDL-C])、甘油三酯(TG)、全血细胞计数、炎症标志物(红细胞沉降率[ESR]和 C 反应蛋白[CRP])。所有患者均行超声心动图和腹部超声检查,以确定 CAD 和胆囊大小。根据 GBD,将 KD 患者分为 GBD 患者和无 GBD 患者。对两组患者的人口统计学和临床数据进行分析。
与无 GBD 患者或发热对照组相比,GBD 患者的血清 LDL-C 水平明显较低(p=0.03)。GBD 患者与无 GBD 患者的炎症指数无显著差异。在本研究中,GBD 不是 CAD 的显著危险因素(比值比=2.0,95%置信区间=0.82-5.3,p=0.16)。
这是第一项强调 KD 患者 GBD 与脂代谢之间关系的研究。本研究为 GBD 与脂代谢之间关系的潜在机制提供了临床见解。