Suthar Renu, Singh Surjit, Bhalla Anil Kumar, Attri Savita Verma
Pediatric Allergy Immunology Unit, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Int J Rheum Dis. 2014 Mar;17(3):304-12. doi: 10.1111/1756-185X.12296. Epub 2014 Feb 11.
Kawasaki disease (KD) has been associated with abnormal lipid profiles. The latter, in turn, have been linked to changes in subcutaneous fat. In this comparative cross-sectional study we have quantified distribution of subcutaneous fat during follow-up of a cohort of North Indian children with KD.
We compared 35 KD children (at least 2 years after disease) and 33 healthy controls. Study parameters included weight, height and skinfold thickness (SFT) over biceps, triceps, midaxillary, subscapular, medial calf and suprailiac areas. Waist and hip circumferences were also recorded. All parameters were measured four times at 6-monthly intervals using standardized techniques. Serum lipids were assayed in the study group.
Study children were enrolled 3.7 ± 2.5 years after KD and mean age at enrolment was 8.26 ± 3.65 years. Suprailiac SFT measured higher in boys with KD (P ≤ 0.05). Biceps SFT was higher in the study group, but the difference was not significant. Other SFT were not affected. Waist and hip circumference was higher in the study group than controls (P ≤ 0.05). Waist/hip circumference ratio was not affected. Serum low-density lipoprotein cholesterol (LDL-C) and triglycerides were higher in the study group as compared to historical controls (95.60 ± 36.12 and 129.40 ± 64.62 mg/dL vs. 80.10 ± 2.20 and 91.1 ± 29.85; P ≤ 0.05). Total cholesterol and high-density lipoprotein cholesterol levels remained unaffected.
Children with KD (especially boys) had increased subcutaneous fat deposition in the suprailiac region and waist, during follow-up. Serum LDL-C and triglycerides were elevated. KD children may have a tendency to develop central obesity. Further studies, with longer follow-up, would be necessary to show whether this has implications for development of coronary artery disease later in life.
川崎病（KD）与血脂异常有关。而血脂异常又与皮下脂肪变化相关。在这项比较性横断面研究中，我们对一组北印度KD患儿随访期间的皮下脂肪分布进行了量化。
我们比较了35名KD患儿（病后至少2年）和33名健康对照。研究参数包括体重、身高以及肱二头肌、肱三头肌、腋中、肩胛下、小腿内侧和髂上区域的皮褶厚度（SFT）。还记录了腰围和臀围。所有参数均使用标准化技术每隔6个月测量4次。对研究组进行血脂检测。
研究患儿在KD发病后3.7±2.5年入组，入组时平均年龄为8.26±3.65岁。KD男孩的髂上皮褶厚度测量值较高（P≤0.05）。研究组的肱二头肌皮褶厚度较高，但差异不显著。其他皮褶厚度未受影响。研究组的腰围和臀围高于对照组（P≤0.05）。腰臀围比未受影响。与历史对照相比，研究组的血清低密度脂蛋白胆固醇（LDL-C）和甘油三酯较高（95.60±36.12和129.40±64.62mg/dL vs. 80.10±2.20和91.1±29.85；P≤0.05）。总胆固醇和高密度脂蛋白胆固醇水平未受影响。
KD患儿（尤其是男孩）在随访期间髂上区域和腰部的皮下脂肪沉积增加。血清LDL-C和甘油三酯升高。KD患儿可能有发生中心性肥胖的倾向。需要进行更长时间随访的进一步研究，以表明这是否对日后冠心病的发生有影响。
