Plasma miR-181a as a Candidate Diagnostic Biomarker for Kawasaki Disease Patients with Coronary Artery lesions

DOI: https://doi.org/10.21203/rs.2.23602/v1

Abstract

Background: Kawasaki disease (KD) is an acute and systemic vasculitis, and the critical complication in KD patients is coronary artery lesions (CAL). Plasma miR-181a was found dysregulated in a variety of cardiovascular disease. The aim of this study was to define the relationship between the plasma miR-181a levels and CAL in KD. Methods: Plasma miR-181a levels were analyzed by quantitative reverse transcriptase-polymerase chain reaction in 121 patients with KD. Results:We found that plasma miR-181a levels at the acute phase were significantly elevated in KD patients with CAL than those without CAL. Correlation analysis showed that plasma miR-181a levels were positively correlated with the concentrations of CRP (r=0.363, P < 0.05) and NT-proBNP (r=0.389, P < 0.05). Receiver operating characteristic curve analyses showed that plasma miR-181a was of significant prediction value for CAL in KD, the area under receiver operating characteristic curve value for plasma miR-181a in prediction of CAL was 0.747, and the estimated sensitivity and specificity were 75.0% and 68.8%, respectively. Conclusions: Plasma miR-181a is prone to be a candidate biomarker for predicting CAL in KD. Therefore, further investigations are warranted to fully elucidate its role in KD.

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Tables

Table 1 Demographic, clinical and laboratory characteristics of patients with KD

Parameter

Median (Range) /No (%)

Age (months)

19.0 (2-144)

Male

78 (64.5%)

Incomplete KD

33 (27.3%)

IVIG resistant

25 (20.7%)

CAL

26 (21.5%)

Mucosal changes

107 (88.4%)

Conjunctival injection

101 (83.5%)

Rash

76 (62.8%)

Changes in extremities

51 (42.1%)

Cervical lymphadenopathy

79 (65.3%)

 

 

Table 2 Comparison of laboratory characteristic in KD patients with and without CAL

 

KD with CAL

KD without CAL

P value

Age (months)

18 (2,120)

19 (2,144)

0.354

Male

18 (69.2%)

56 (58.9%)

0.340

WBC (×109/l)

17.85±6.87

15.54±5.35

0.082

Neutrophil (×109/l)

12.70±5.77

10.43±4.49

0.043*

Lymphocyte (×109/l)

3.59±2.10

3.61±2.14

0.961

Hemoglobin (g/l)

101.56±12.80

103.59±10.98

0.362

Platelet (×109/l)

372.53±152.43

350.56±107.05

0.444

CRP  (mg/dl)

118.83±65.46

99.06±60.52

0.012*

ESR  (mm/h)

64.84±23.82

60.27±27.51

0.368

PCT  (ng/ml)

1.44±1.77

2.25±13.04

0.530

NT-proBNP  (pg/ml)

1393.35±1792.47

636.57±771.91

0.025*

SF (ng/ml)

288.84±311.36

279.70±198.82

0.311

 

 

Table 3 Correlation between circulating miR-181a levels and other laboratory data in KD patients

 

Correlation coefficient

P value

WBC

0.019

0.807

Neutrophil

-0.016

0.838

Lymphocyte

0.086

0.263

Hemoglobin

-0.039

0.609

Platelet

-0.006

0.933

CRP

0.363

<0.001

ESR

0.041

0.595

PCT

-0.058

0.451

NT-proBNP

0.389

<0.001

SF

0.132

0.084