Mechanism of the Influence of Age and Body Mass Index on Vascular Endothelial Function and Coronary Artery Lesion in Children with Kawasaki Disease
XIA Kun
ZHANG Yong
ZHOU Dan
FU Jia
FU Jie
Abstract：Objective To investigate the mechanism of influence of age and body mass index(BMI)on vascular endothelial function and coronary artery lesion(CAL)in children with Kawasaki disease(KD).Methods The clinical data of 200 children with KD admitted to Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science and Technology from April 2024 to January 2025 were retrospectively collected.The patients were divided into an infant group(<1 year,n=84),a toddler group(1-3 years,n=57),and a preschool group(4-6 years,n=59)according to age.Based on the 85th and 95th percentile of BMI for children of the same age and sex,they were classified into a normal group(n=119),an overweight group(n=42),and an obesity group(n=39).According to the presence of CAL,they were divided into a CAL group(n=86)and a non-CAL group(n=114).Vascular endothelial function indices were compared among children with KD of different ages and BMI categories.Clinical data were compared between the CAL group and the non-CAL group.Multivariate logistic regression analysis was used to identify influencing factors for CAL in children with KD.Results The carotid intima-media thickness(IMT)and carotid stiffness index(SI)in the infant group were higher than those in the young children group and the preschool group(P<0.05),while the reactive hyperemia index(RHI),flow-mediated dilation(FMD),and nitroglycerin-mediated dilation(NMD)were significantly lower than those in the young children group and the preschool group(P<0.05).The IMT in the young children group was significantly higher than that in the preschool group(P<0.05).IMT and SI in the obese group were significantly higher than those in the overweight group and the normal group(P<0.05),while RHI,FMD,and NMD were significantly lower than those in the normal group(P<0.05).IMT in the overweight group was significantly higher than that in the normal group(P<0.05),while RHI,FMD,and NMD were significantly lower than those in the normal group(P<0.05).The proportion of children aged≤3 years,the proportion of overweight/obese children,and the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),IMT,and SI in the CAL group were significantly higher than those in the n-CAL group(P<0.05),while the levels of RHI,FMD,and NMD in the CAL group were significantly lower than those in the n-CAL group(P<0.05).Multivariate Logistic regression analysis showed that age,BMI,CRP,TNF-α,IMT,SI,RHI,FMD,and NMD were independent influencing factors for CAL in children with KD(P<0.05).Conclusion Vascular endothelial function differs in children with KD of different ages and BMI,and age,BMI,CRP,TNF-α,IMT,SI,RHI,FMD,and NMD are independent influencing factors for CAL occurrence in children with KD.
Keywords：Kawasaki diseasecoronary artery lesionvascular endothelial functionagebody mass index
Publication Date：2025-12-20
Online Publishing Date：2025-12-25(First online date of this platform, not the publication date of the document)
Pages：5( 16-20 )