Predictive value of serum HMGB1 and Angptl-2 on coronary artery damage in children with Kawasaki disease

DING Fenqin; XU Fei; QIN Jie

doi:10.11958/20242018

Abstract：Objective To investigate the impact and predictive value of high mobility group protein B1(HMGB1)and angiopoietin like protein 2(Angptl-2)on coronary artery damage in children with Kawasaki disease.Methods A total of 114 children with Kawasaki disease were selected and divided into the normal coronary artery group(85 cases)and the coronary artery lesion group(29 cases)according to the presence or absence of coronary artery lesions.The general clinical data of the two groups were compared.Enzyme linked immunosorbent assay was applied to detect serum levels of HMGB1 and Angptl-2 in children and compared between the two groups.Logistic regression was applied to analyze the influencing factors of coronary artery damage in children with Kawasaki disease.Receiver operating curve(ROC)was applied to analyze the predictive value of serum levels of HMGB1 and Angptl-2 for coronary artery damage in children with Kawasaki disease.Results The serum levels of HMGB1 and Angptl-2 were significantly higher in acute stage than those in remission stage(P＜0.05).Before treatment,the duration of fever,white blood cell count,erythrocyte sedimentation rate,procalcitonin and serum HMGB1 and Angptl-2 levels were significantly higher in the coronary artery lesion group than those in the normal coronary artery group(P＜0.05).Logistic regression analysis showed that the duration of fever,white blood cell count,erythrocyte sedimentation rate,procalcitonin,HMGB1 and Angptl-2 levels before treatment were all independent risk factors for coronary artery damage in children with Kawasaki disease(P＜0.05).The area under the curve(AUC)of serum HMGB1 and Angptl-2 for diagnosing coronary artery damage in children with Kawasaki disease was 0.907(95%CI:0.838-0.953)and 0.857(95%CI:0.780-0.916),respectively,with cut-off value of 59.62 μg/L and 10.35 μg/L,respectively.The AUC,sensitivity and specificity of the combined diagnosis of coronary artery damage in children with Kawasaki disease were 0.958(95%CI:0.903-0.987),93.10%and 90.59%,respectively,which were better than their individual diagnose.Conclusion The serum levels of HMGB1 and Angptl-2 are obviously elevated in children with Kawasaki disease complicated by coronary artery damage,and the combined detection of HMGB1 and Angptl-2 levels in serum can provide a good prediction for coronary artery damage in children with Kawasaki disease.