Association of Serum CHI3L1 and Systemic Inflammatory Markers in Peripheral Blood with Disease Severity during Acute Phase of Wheezing in Infants and Toddlers

WANG Shuyu; ZHENG Yibo; YANG Lei; LI Shiyun; LIU Fan; ZHANG Wei

doi:10.3969/j.issn.1002-3429.2025.11.011

Abstract：Objective To investigate the value of serum CHI3L1,systemic inflammatory markers in peripheral blood[neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII)]in evaluation of acute wheezing in infants and toddlers and their correlation with disease severity.Methods Seventy infants and toddlers with acute phase of wheezing admitted to Pediatric Department from June 2021 to May 2023 were enrolled in the study.According to the disease severity,they were divided into mild wheezing group(n=44)and severe wheezing group(n=26).Another 22 healthy infants and toddlers undergoing physical examination during the same period were selected as controls(control group).Serum CHI3L1 levels were detected by enzyme-linked immunosorbent assay(ELISA)in infants and young children in each group,and blood routine was also measured to calculate NLR,PLR and SII.Pearson correlation analysis was used to analysis the correlation of CHI3L1 with NLR,PLR and SII in infants and toddlers with acute phase of wheezing.The receiver operating characteristic(ROC)curve was used to analyze the predictive efficacy for severe wheezing.Results The level of serum CHI3L1 in severe wheezing group were significantly higher than that in mild wheezing group and control group,and significantly higher in mild wheezing group than in control group(P<0.05).NLR,PLR and SII in severe wheezing group were significantly higher than that in mild wheezing group and control group(P<0.05).Pearson correlation analysis showed that serum CHI3L1 level was positively correlated with NLR,PLR and SII in infants and toddlers with acute phase of wheezing(P<0.05 or P<0.01).ROC curve analysis showed that CHI3L1,NLR,PLR,SII and joint detection had an area under the ROC curve(AUC)of 0.799,0.772,0.710,0.798 and 0.890,respectively,with a sensitivity of 61.5%,53.8%,61.5%,73.1%and 92.3%,respectively,and a specificity of 82.5%,87.5%,80.0%,85.0%and 72.5%,respectively.Conclusion Serum CHI3L1,NLR,PLR and SII are positively correlated with disease severity in infants and toddlers with acute phase of wheezing.Combined detection can be valuable for early estimation of disease severity during acute phase of wheezing in infants and toddlers.