Chen Ye, Huang Wanlin, Hou Miao, Wang Shuhui, Cao Lei, Li Xuan, Lv Haitao
Department of Cardiology, Children's Hospital of Soochow University, Suzhou, China.
Department of Pediatrics, Suzhou Municipal Hospital, Suzhou, China.
Front Pediatr. 2025 Jun 12;13:1583603. doi: 10.3389/fped.2025.1583603. eCollection 2025.
To explore the application value of the urinary albumin-to-creatinine ratio (UACR) in the predictive of coronary artery (CA) abnormalities in Kawasaki disease (KD) during acute phase.
This retrospective study included 109 KD patients who were stratified into CA abnormalities and normal CA groups based on echocardiography at one month after KD onset. Clinical, demographic, and laboratory data were analyzed. Urinary microalbumin and urinary creatinine values were collected during the acute phase before high-dose intravenous immunoglobulin (IVIG) therapy, and UACR was calculated.
The 109 patients consisted of 70 males and 39 females. The orrelation analysis revealed no significant associations between UMA and serum albumin (Alb) ( = -0.073, = 0.449), or between UACR and serum Alb ( = -0.128, = 0.186) in KD patients. Among the 109 patients, 23 (21.1%) developed CA abnormalities. The levels of UACR, CRP, ALT and NT-proBNP were significantly elevated in the CA abnormalities group compared to the normal CA group, while serum Alb and prealbumin (PA) were decreased ( < 0.05). Multivariate binary logistic regression analysis identified elevated UACR and reduced serum Alb levels as independent predictors of CA abnormalities ( < 0.05). The optimal cutoff values for UACR and serum Alb were 24.1 mg/g and 37.75 g/L, respectively. Combined UACR and serum Alb, the predictive performance improved, with an area under the curve (AUC) of 0.904 (95% CI: 0.848-0.961), a sensitivity of 91.3%, and a specificity of 81.4%.
UACR and serum Alb, assessed during the acute phase of KD, could serve as early biomarkers for CA abnormalities, particularly when analyzed in combination.
探讨尿白蛋白与肌酐比值（UACR）在预测川崎病（KD）急性期冠状动脉（CA）异常中的应用价值。
这项回顾性研究纳入了109例KD患者，根据KD发病后1个月的超声心动图结果将其分为CA异常组和CA正常组。对临床、人口统计学和实验室数据进行分析。在大剂量静脉注射免疫球蛋白（IVIG）治疗前的急性期收集尿微量白蛋白和尿肌酐值，并计算UACR。
109例患者中，男性70例，女性39例。相关性分析显示，KD患者中尿微量白蛋白（UMA）与血清白蛋白（Alb）之间无显著相关性（r = -0.073，P = 0.449），UACR与血清Alb之间也无显著相关性（r = -0.128，P = 0.186）。109例患者中，23例（21.1%）出现CA异常。与CA正常组相比，CA异常组的UACR、CRP、ALT和NT-proBNP水平显著升高，而血清Alb和前白蛋白（PA）降低（P < 0.05）。多因素二元逻辑回归分析确定UACR升高和血清Alb水平降低是CA异常的独立预测因素（P < 0.05）。UACR和血清Alb的最佳截断值分别为24.1 mg/g和37.75 g/L。联合UACR和血清Alb，预测性能提高，曲线下面积（AUC）为0.904（95%CI：0.848 - 0.961），灵敏度为91.3%，特异度为81.4%。
在KD急性期评估的UACR和血清Alb可作为CA异常的早期生物标志物，尤其是联合分析时。
