Changes Of 25-hydroxyvitamin D₃ And Its Clinical Significance In Children With Kawasaki Disease

Objective: To observe the changes of serum 25-hydroxyvitamin D3[25-(OH)D3] levels in children with Kawasaki disease(KD),analyze the correlation between 25-(OH)D3 and other laboratory indexes and explore its association with coronary artery lesion(CAL)and resistance to intravenous immunogobulin(IVIG)in KD.Methods: 68 children withKDin the acute phase were enrolled and divided into two groups based on the presence or absence of CAL: 25 cases in CAL group and 43 cases in NCAL group.All the patients were also divided into two groups according to the efficacy of IVIG: 54 cases in IVIG-sensitive group and 14 patients in IVIG-resistant group,While 30 healthy children of similar age and sex were recruited as control group.Collect all the baseline data,echocardiography results and laboratory indexex of theKDpatients including blood routine tests,blood biochemistry indexes,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR)and serum ferritin(SF).All the levels of serum 25-(OH)D3 by chemiluminescence were obtained in control group andKDgroup during acute and convalescence phase.Results: 1.Serum 25-(OH)D3 levels in children with KDwere significantly lower than the control group during the acute phase(P<0.05).The levels increased during convalescence phase after IVIG treatment,but they were still lower than the control group(P < 0.05).2.Serum25-(OH)D3 levels in CAL group and the NCAL group during the acute phase were significantly lower than in control group while they were the lowest in the CAL group,there were statistical differences between each group(P<0.01).3.Serum 25-(OH)D3 levels in IVIG-resistant group and the IVIG-sensitive group during acute phase were significantly lower than the control group while they were the lowest in IVIG-resistant group,there were statistical differences between each group(P<0.05).4.The correlation analysis revealed that there was a negative correlation between Serum 25-(OH)D3 levels and the levels of SF,red cell distribution width(RDW),mean platelet volume(MPV)and serum creatinine(SCr)in children withKDin acute phase(r=-0.36,r=-0.29,r=-0.41,r=-0.38;P<0.05).Conclusion: Significantly decreased serum 25-(OH)D3 levels may be closely associated with the occurrence of CAL and IVIG-resistant.There was a negative correlation between Serum25-(OH)D3 levels and the levels of SF,RDW,MPV and SCr in children with KDin acute phase,which may indicate the decrease of vitamin D level is related with inflammation,platelet activation,cardiovascular damage and renal injury in patients with KD.