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  • Clinical Research Article
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Kawasaki disease coronary artery lesions prediction with monocyte-to-high-density lipoprotein ratio

Pediatric Research volume 94, pages 246–251 (2023)Cite this article

Abstract

Objective

The aim of this study was to evaluate the predictive value of the monocyte-to-high-density lipoprotein ratio (MHR) in Kawasaki disease (KD) complicated with coronary artery lesions (CALs) and to construct a nomogram prediction model.

Methods

The medical records of KD inpatients diagnosed in the Department of Pediatrics of Lanzhou University Second Hospital from May 2015 to September 2021 were retrospectively analyzed. ROC curves were applied to evaluate the predictive value of MHR in KD complicated with CALs, and logistic regression analysis was used to screen independent risk factors. We constructed a nomogram model and performed internal validation.

Results

A total of 568 KD patients were enrolled in the study. MHR was significantly higher in KD patients complicated with CALs and was identified as an independent risk factor for CALs (OR: 1.604, 95% CI: 1.292–1.990). The area under the ROC curve for MHR in predicting CALs was 0.661. The C-index of the nomogram model constructed by incorporating MHR was 0.725 (95% CI: 0.682–0.768), and the calibration curve revealed good agreement between the predicted and actual probabilities.

Conclusions

MHR may not be suitable as a single biomarker to predict the occurrence of CALs, but the nomogram model constructed in combination with other independent risk factors had acceptable predictive performance.

Impact

  • The inflammatory response plays an important role in the pathogenesis of Kawasaki disease.

  • The monocyte-to-high-density lipoprotein ratio is a novel systemic inflammation marker.

  • The monocyte-to-high-density lipoprotein ratio is an independent risk factor for Kawasaki disease complicated with coronary artery lesions.

  • The nomogram established by incorporating the monocyte-to-high-density lipoprotein ratio has satisfactory predictive performance for coronary artery lesion formation.

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Fig. 1: ROC curves of the MHR, NLR, CAR, and SII for predicting KD complicated with CALs.
Fig. 2: Individual risk nomogram for KD complicated with CALs.
Fig. 3: Nomogram calibration curve for KD complicated with CALs.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank the Department of Pediatrics of Lanzhou University Second Hospital for providing us with data support. This work was supported by the Natural Science Foundation of Gansu Province (20JR10RA599), Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital (2020QN-22), and Cuiying Scientific Training Program for Undergraduates of Lanzhou University Second Hospital (CYXZ2021-67).

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Author notes

  1. These authors contributed equally: Chao Yang, Yinan Yang.

Authors and Affiliations

  1. Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, 730000, China

    Chao Yang, Shuting Cao, Zhibin Ma, Hongmei Du, Jianjian Li, Feng Dou, Yini Zhao & Xiaobin Hu

  2. Department of Pediatrics, Lanzhou University Second Hospital, Lanzhou, Gansu, 730030, China

    Yinan Yang

  3. The Second School of Clinical Medicine, Lanzhou University, Lanzhou, Gansu, 730030, China

    Xiaomin Li

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Contributions

C.Y.: conceptualization, investigation, methodology, writing—original draft. Y.Y.: resources, validation, supervision, writing—review and editing. S.C.: investigation, software. Z.M.: investigation, visualization. H.D., J.L., F.D., Y.Z., X.L.: investigation. X.H.: conceptualization, methodology, supervision, data curation, writing—review and editing.

Corresponding author

Correspondence to Xiaobin Hu.

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The authors declare no competing interests.

Ethics approval and consent to participate

This study was approved by the Medical Ethics Committee of Lanzhou University Second Hospital (No. 2021A-058), and the requirement for informed consent was waived.

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Yang, C., Yang, Y., Cao, S. et al. Kawasaki disease coronary artery lesions prediction with monocyte-to-high-density lipoprotein ratio. Pediatr Res 94, 246–251 (2023). https://doi.org/10.1038/s41390-022-02401-4

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