Abstract:Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D (25-[OH]D)levels in children with Kawasaki disease(KD).Methods The clinical data of 147 children aged 1-3 years old with KD hospitalized in our hospital from September 2009 to September 2017 were retrospectively analyzed.According to whether coronary artery lesion(CAL)occured,they were divided into the CAL group(76 cases)and the non-CAL group(NCAL,71 cases).According to the efficacy of intravenous immunglobulin (IVIG),they were divided into the immunglobulin sensitive KD group(117 cases)and the immunglobulin unresponsive KD group(30 cases).Another 58 healthy children of this age during the same period were selected as the control group.Serum 25-(OH)D levels were measured by enzyme-linked immunosorbent assay among the groups.Results The level of serum 25-(OH)D in the CAL group was(33.24±7.74)nmol/L,which was lower than that in the NCAL group accounting for(38.72±10.82)nmol/L and the control group accounting for(43.00±13.10)nmol/L,and the differences were statistically significant(P<0.05).The level of serum 25-(OH)D in the NCAL group was lower than that in the control group,and the difference was statistically significant(P<0.05).The level of serum 25-(OH)D in the immunglobulin unresponsive KD group was(32.60±6.41)nmol/L,which was lower than that in the immunglobulin sensitive KD group accounting for(36.79±10.31)nmol/L and the control group accounting for(43.00±13.10)nmol/L,and the differences were statistically significant(P<0.05).The level of serum 25-(OH)D in the immunglobulin sensitive KD group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions The level of serum 25-(OH)D is low in children with KD,and it is much lower especially in the incidence of CAL and under the immunglobulin unresponsive condition.
章晓英;李超雄;欧仲爱;林娜娜;郑晓燕. 川崎病患儿血清中25-羟基维生素D水平的变化及临床意义[J]. 中国当代医药, 2019, 26(5): 98-100-104.
ZHANG Xiao-ying;LI Chao-xiong;OU Zhong-ai;LIN Na-na;ZHENG Xiao-yan. Changes and clinical significance of serum 25-hydroxyvitamin D levels in children with Kawasaki disease. 中国当代医药, 2019, 26(5): 98-100-104.
Rejnmark L,Bislev LS,Cashman KD,et al.Non-skeletal health effects of vitamin D supplementation:a systematic review on findings from meta-analyses summarizing trial data[J].PLoS One,2017,12(7):e0180512.
[3]
Zittermann A.The biphasic effect of vitamin D on the musculoskeletal and cardiovascular system[J].Int J Endocrinol,2017,(1-1):3 206 240.
[4]
Mozos L,Marginean O.Links between Vitamin D deficiency and cardiovascular disease[J].Biomed Res Int,2015,4:1-12.
McCrindle BW,Rowley AH,Newburger JW,et al.American HeartAssociationRheumaticFever,Endocarditis,andKawasaki Disease Committee of the Council on Cardiovascular Disease in the Young;Council on Cardiovascular and Stroke Nursing;Council on Cardiovascular Surgery and Anesthesia;and Council on Epidemiology and Prevention.Diagnosis,treatment,and long-term management of Kawasaki disease:a scientific statement for health professionals from the American Heart Association[J].Circulation,2017,135:927-999.
[7]
Eleftheriou D,Levin M,Shingadia D,et al.Management of Kawasaki disease[J].Dis Child,2014,99:74-83.
Cashman KD.A review of vitamin D status and CVD[J].Proc Nutr Soc-engl Scot,2014,73(1):65-72.
[11]
Stagi S,Rigante D,Lepri G,et al.Severe vitamin D deficiency in patients with Kawasaki disease:a potential role in the risk to develop heart vascular abnormalities?[J].Clin Rheumatol,2016,35:1865-1872.
Newburger JW,Takahashi M,Gerber MA,et al.Diagnosis,treatment,and long-term management of Kawasaki disease:a statement for health professionals from the Committee on Rheumatic Fever,Endocarditis,and Kawasaki Disease,Council on Cardiovascular Disease in the Young,American Heart Association[J].Pediatrics,2004,114:1708-1733.
[16]
An XJ,Fu MY,Tian J,et al.Significance of serum 25-hydroxyvitamin D3 and interleukin-6 levels in immunoglobulin treatment of Kawasaki disease in children[J].Exp Ther Med,2016,12(3):1476-1480.
[17]
Matsubara T,Ichiyama T,Furukawa S.Immunological profile of peripheral blood lymphocytes and monocytes/macrop hages in Kawasaki disease[J].Clin Exp Immunol,2005,141:381.
[18]
Jae Sung Jnu MD,Young Kwon Jung MD,Dong Won Lee MD.Relationship between vitamin D levels and intravenous immunoglobulin resistance in Kawasaki disease[J].Korean J Pediatr,2017,60(7):216-220.