Correlation of serum levels of trimethylamine N-oxidein patients with Kawasaki disease and coronary artery lesions

SHI Tong-tong; LIU Lu; GAO Jun; AN Xin-jiang; WANG Fei

doi:10.3969/j.issn.1672-5301.2025.06.013

Abstract：Objective This study aimed to investigate the correlation between serum levels of Trimethylamine N-oxide(TMAO)concerning Kawasaki disease(KD)and its associated coronary artery lesions(CAL).Methods A total of 160 children with KD who were admitted to the Cardiovascular Department of Xuzhou Children's Hospital for treatment from January 2022 to December 2023 and were clinically diagnosed with KD were selected as the KD group.The KD group was further categorized based on coronary artery examination via echocardiography into two subgroups:those with coronary artery lesions(CAL group)and those without coronary artery lesions(NCAL group).Additionally,80 cases of common fever patients and 80 healthy children undergoing regular health check-ups were included as control groups.Serum levels of TMAO were assessed using enzyme-linked immunosorbent assay across these groups.Results Serum TMAO levels in children with KD in the acute stage were significantly higher than those in the common fever patients and healthy control group[3.89(3.90,5.57)μmol/L vs.2.56(1.91,3.27)μmol/L vs.2.08(1.67,3.05)μmol/L,P＜0.05].Serum TMAO levels were significantly higher in the acute,sub-acute and convalescence stage in the CAL group than in the NCAL group[4.62(3.41,6.26)μmol/L vs.3.47(2.55,5.09)μmol/L,3.68(2.61,5.48)μmol/L vs.2.98(2.19,4.48)μmol/L,2.52(1.71,3.76)μmol/L vs.1.98(1.07,3.53)μmol/L,all P＜0.05].Elevated serum TMAO was an independent risk factor for CAL in Kawasaki disease(Oβ=1.291,95％CI 1.028-1.622;P=0.028).The area under the curve for serum TMAO detection for early KD screening was 0.77.Optimal cut-off values were 3.14 μmol/L with corresponding sensitivities of 71.3％,and specificities of 72.5％.In predicting CAL,the area under the curve for serum TMAO detection was 0.66.Optimal cut-off values were 3.24 μmol/L with corresponding sensitivities of 83.3％,and specificities of 43.6％.Conclusion Correlation exists between serum TMAO and the onset and progression of KD and CAL.Its assessment demonstrates potential clinical value in early KD identification and prediction of CAL.