ShuHan Huang, ZhiMeng Huang, YaXuan Lin, JingXuan Fang, RuiQi Chen, WenXing Guo, HuiFen Zhang, Xiaoqing Yang, Wu JinZhun, LiLin Zhong
Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen university, Xiamen, 361003, Fujian, China.
Department of Pediatrics, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, 361102, Fujian, China.
Pediatr Res. 2025 May 13. doi: 10.1038/s41390-025-04116-8.
We studied whether ozone (O) exposure will affect the occurrence of KD, in Xiamen.
A time-stratified case-crossover design was conducted to explore the relationship between O exposure and KD in children. A total of 604 participants from 2017 to 2024 were included. Artificial intelligence technology combined with large data model was used to calculate O concentration, and O exposure was assigned to each participant. Poisson generalized additive model was used to calculate the risk effect of O and KD. Correlation and mediation analysis were used to study the mechanism of KD.
When lag 2 to 6 days, O exposure will increase the occurrence of KD. On the 4th day of lag, O led to the highest risk of KD, relative risk(RR) = 1.09(95%CI = 1.008, 1.19). The results of mediation analysis showed that clinical indicators such as white blood cell (WBC), neutrophil (NEUT), and C-reactive protein (CRP) were the main mediators regulating the association between O and KD.
Our results show that exposure to O is a potential risk factor for KD in children, and clinical indicators such as WBC, NEUT, PLT and CRP are the main mediators regulating O and KD.
We studied the association between O exposure and the incidence of KD, and further analyzed the regulatory role of clinical indicators in this association. On the 4th day of lag, O led to the highest risk of KD, RR = 1.09(95%CI = 1.008,1.19). The relationship between O exposure and KD is mainly mediated by clinical indicators such as WBC, NEUT, PLT and CRP. Our findings explain the association between O3 exposure and the incidence of KD, and further analyze the regulatory role of clinical indicators in the association. It is helpful to provide theoretical support for subsequent research.
我们研究了在厦门臭氧（O）暴露是否会影响川崎病（KD）的发生。
采用时间分层病例交叉设计探讨儿童O暴露与KD之间的关系。纳入了2017年至2024年的604名参与者。利用人工智能技术结合大数据模型计算O浓度，并将O暴露分配给每位参与者。采用泊松广义相加模型计算O与KD的风险效应。运用相关性和中介分析研究KD的发病机制。
当滞后2至6天，O暴露会增加KD的发生。在滞后第4天，O导致KD的风险最高，相对风险（RR）=1.09（95%置信区间=1.008，1.19）。中介分析结果表明，白细胞（WBC）、中性粒细胞（NEUT）和C反应蛋白（CRP）等临床指标是调节O与KD关联的主要中介因素。
我们的结果表明，O暴露是儿童KD的一个潜在危险因素，WBC、NEUT、血小板（PLT）和CRP等临床指标是调节O与KD关系的主要中介因素。
我们研究了O暴露与KD发病率之间的关联，并进一步分析了临床指标在这种关联中的调节作用。在滞后第4天，O导致KD的风险最高，RR=1.09（95%置信区间=1.008，1.19）。O暴露与KD之间的关系主要由WBC、NEUT、PLT和CRP等临床指标介导。我们的研究结果解释了O3暴露与KD发病率之间的关联，并进一步分析了临床指标在该关联中的调节作用。有助于为后续研究提供理论支持。
