Department of Pediatrics, Japanese Red Cross Narita Hospital, Chiba, Japan.
Department of Pediatrics, Yachiyo Medical Center, Tokyo Women's Medical University of Medicine, Chiba, Japan.
Pediatr Int. 2022 Jan;64(1):e15191. doi: 10.1111/ped.15191.
The seasonal epidemic of Kawasaki disease (KD) in winter in Japan suggests that low vitamin D status may affect KD through the immune system. We aimed to evaluate the effect of vitamin D on the onset and clinical course of KD.
We conducted a case-control study to compare 25-hydroxyvitamin D (25(OH)D) levels in KD patients admitted to our hospital between March 2018 and June 2021, with those in healthy controls from published Japanese data. In patients with KD, we evaluated the association of 25(OH)D levels with intravenous immunoglobulin resistance and coronary artery lesions.
We compared 290 controls and 86 age-group-adjusted patients with KD. The 25(OH)D levels in KD patients were lower than those in the controls (median: 17 vs. 29 ng/mL, P < 0.001). In winter, 25(OH)D levels in KD patients were lower than those in summer (median: 13 vs. 19 ng/mL). The adjusted odds ratios for the onset of KD were 4.9 (95% CI: 2.5-9.6) for vitamin D insufficiency (25(OH)D: 12-20 ng/mL) and 29.4 (95% CI: 12.5-78.2) for vitamin D deficiency (25(OH)D < 12 ng/mL). Among 110 KD patients, 25(OH)D levels at diagnosis of KD were not associated with intravenous immunoglobulin resistance or coronary artery lesions.
The 25(OH)D levels in patients with KD were lower than those in the controls, especially in winter. Lower 25(OH)D levels in winter were associated with an increased risk of KD onset. It remains to be elucidated whether the observed association has a causal relationship.
日本冬季川崎病（KD）的季节性流行表明，维生素 D 状态低下可能通过免疫系统影响 KD。我们旨在评估维生素 D 对 KD 发病和临床过程的影响。
我们进行了一项病例对照研究，比较了 2018 年 3 月至 2021 年 6 月期间我院收治的 KD 患者与来自日本已发表数据的健康对照者的 25-羟维生素 D（25（OH）D）水平。在 KD 患者中，我们评估了 25（OH）D 水平与静脉注射免疫球蛋白耐药和冠状动脉病变的关系。
我们比较了 290 名对照者和 86 名年龄匹配的 KD 患者。KD 患者的 25（OH）D 水平低于对照组（中位数：17 与 29ng/ml，P<0.001）。在冬季，KD 患者的 25（OH）D 水平低于夏季（中位数：13 与 19ng/ml）。维生素 D 不足（25（OH）D：12-20ng/ml）和维生素 D 缺乏（25（OH）D<12ng/ml）的 KD 发病调整比值比分别为 4.9（95%可信区间：2.5-9.6）和 29.4（95%可信区间：12.5-78.2）。在 110 例 KD 患者中，KD 诊断时的 25（OH）D 水平与静脉注射免疫球蛋白耐药或冠状动脉病变无关。
KD 患者的 25（OH）D 水平低于对照组，尤其是在冬季。冬季较低的 25（OH）D 水平与 KD 发病风险增加相关。尚需阐明观察到的关联是否存在因果关系。
