Hu Linjie, Zhou Peng, Wang Shanlin, Shen Yaping, Xing Suli, Zhang Yuehan, Zhu Yanyan
Department of Pediatric, Shengzhou People's Hospital (Shengzhou Branch of The First Affiliated Hospital of Zhejiang University School of Medicine, The Shengzhou Hospital of Shaoxing University), Shengzhou, Zhejiang, 312400, People's Republic of China.
Department of Pediatric, Hangzhou Children's Hospital, Hangzhou, Zhejiang, 310014, People's Republic of China.
Int J Gen Med. 2025 Sep 4;18:5155-5169. doi: 10.2147/IJGM.S538528. eCollection 2025.
Absent in melanoma 2 (AIM2) is associated with inflammation. We intended to determine whether serum AIM2 levels are related to severity and complications of community-acquired pneumonia (CAP) in children.
In this prospective cohort study, serum AIM2 levels were measured in 305 children with CAP and in 100 healthy controls at the Hangzhou Children's Hospital between January 2022 and June 2023. CAP severity was assessed using the pediatric critical illness score (PCIS) and clinical pulmonary infection score (CPIS). In-hospital complicated CAP was identified as the outcome variable. Univariate and multivariate analyses were sequentially performed to determine the correlation between severity, outcome and serum AIM2 levels.
Children with CAP had higher serum AIM2 levels than controls (median, 1.45 ng/mL versus 0.36 ng/mL; P<0.001). Serum AIM2 levels in diseased children were independently correlated with PCIS (beta=-0.020; P=0.001) and CPIS (beta=0.092; P=0.002), were linearly related to likelihood of complicated CAP (P for nonlinear =0.057), and were independently associated with complicated CAP (odds ratio= 6.162; P=0.005). The outcome association was robust by calculating the E-value at 11.8 and was not moderated by age, sex, weight and more (all P interaction >0.05). Serum AIM2 levels and two independent predictors, PCIS and CPIS, were integrated to construct the model. The model was pictorially represented by the nomogram and exhibited satisfactory discrimination capability, validity, and stability under the receiver operating characteristic (ROC) curve, decision curve, and calibration curve. By computing the net reclassification improvement and integrated discrimination improvement indices and comparing the area under the ROC curve, the model significantly outperformed the combination of the PCIS and CPIS.
Markedly enhanced serum AIM2 levels following CAP in children are highly linked to severity and complicated CAP, substantializing serum AIM2 as a biochemical metric for assessing the severity and identifying adverse outcomes of childhood CAP.
黑色素瘤缺失2（AIM2）与炎症相关。我们旨在确定血清AIM2水平是否与儿童社区获得性肺炎（CAP）的严重程度及并发症相关。
在这项前瞻性队列研究中，于2022年1月至2023年6月期间在杭州市儿童医院对305例CAP患儿及100名健康对照者测定血清AIM2水平。采用儿科危重病评分（PCIS）和临床肺部感染评分（CPIS）评估CAP的严重程度。将院内发生并发症的CAP确定为结局变量。依次进行单因素和多因素分析以确定严重程度、结局与血清AIM2水平之间的相关性。
CAP患儿的血清AIM2水平高于对照组（中位数，1.45 ng/mL对0.36 ng/mL；P<0.001）。患病儿童的血清AIM2水平与PCIS（β=-0.020；P=0.001）和CPIS（β=0.092；P=0.002）独立相关，与并发CAP的可能性呈线性相关（非线性P=0.057），且与并发CAP独立相关（比值比=6.162；P=0.005）。通过计算E值为11.8，结果关联稳健，且不受年龄、性别、体重等因素影响（所有P交互作用>0.05）。整合血清AIM2水平及两个独立预测指标PCIS和CPIS来构建模型。该模型用列线图直观表示，在受试者工作特征（ROC）曲线、决策曲线和校准曲线下表现出令人满意的区分能力、有效性和稳定性。通过计算净重新分类改善和综合鉴别改善指数并比较ROC曲线下面积，该模型显著优于PCIS和CPIS的组合。
儿童CAP后血清AIM2水平显著升高与严重程度及并发CAP密切相关，证实血清AIM2可作为评估儿童CAP严重程度及识别不良结局的生化指标。
