Associate Professor Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, United States
Introduction/Rationale: Kawasaki disease (KD) is the most common acquired cardiovascular disease in young children under five years old. KD is characterised by inflammation in small or medium-sized arteries along with a febrile illness lasting more than five days. Coronary artery lesions (CALs) or coronary artery abnormalities (CAA) develop in 10–33% of KD patients. Currently, there are no reliable biomarkers for KD diagnosis or for predicting CAAs. This study aimed to identify altered plasma lipid metabolites in KD and CAA.
Methods: Blood samples were collected from healthy children (HC), febrile controls (FC), and KD patients after obtaining written informed consent and assent. KD patients were diagnosed as American Heart Association (AHA) criteria. One hundred forty lipid metabolites in plasma were quantified using the P180 kit (Biocrates, Austria) and analyzed in tandem mass spectrometry (LC-MS/MS; ABI Sciex 4500) according to manufacturer instructions. ANOVA was used to compare metabolite levels among groups, applying a significance threshold of 0.05 and p-value adjustment with the Benjamini–Hochberg method.
Results: Sixty five KD patients, 15 HC and 17 FC were recruited. The median ages (range) of KD, HC, and FC groups were 5 (9.9), 3 (8), and 4 (9) years, respectively. Lysophosphatidylcholine (LPC) 18:2 and phosphatidylcholine (PC) 42:5 levels were lower in KD patients than in controls. The ratio of polyunsaturated fatty acid (PUFA)-phosphatidylcholines (PUFA-PCs) to saturated fatty acid (SFA)-phosphatidylcholines (SFA-PCs) was reduced in KD. Among KD patients, the SFA-containing PCs PC 30:0, PC O-30:0, PC O-34:0, and PC O-38:1 were higher in those with CAA than without CAA.
Conclusion: A reduced PUFA-PCs to SFA-PCs ratio was identified in children with KD, with the lowest levels observed in KD with CAA compared to without CAA. This lipid profile distinction may aid in understanding KD pathophysiology and identifying children at increased risk for CAA.
