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Overweight,obesity and coronary artery lesions among Kawasaki disease patients
Authors:Hongying Shi  Fengfeng Weng  Chen Li  Zengyou Jin  Junyong Hu  Maoping Chu  Huixian Qiu
Institution:1. Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, 325035, Zhejiang, China;2. Children''s Heart Center, The Second Affiliated Hospital and Yuying Children''s Hospital of Wenzhou Medical University, Wenzhou 3250002, Zhejiang, China;3. Department of Pediatrics, Affiliated Hangzhou First People''s Hospital, Zhejiang University School of Medicine, Zhejiang, 310051, China;4. Department of Pediatrics, The Children''s Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310051, Zhejiang, China;5. Department of Pediatrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, Zhejiang, China
Abstract:Background and aimsOverweight is associated with increased cardiovascular disease in general populations. However, a similar relationship among Kawasaki Disease (KD) patients was unclear. The study aimed to investigate the relation between weight-for-height and coronary artery lesions (CAL) among KD patients, and whether laboratory indices modified this relation.Methods and resultsAll consecutive KD patients from January 2009 to December 2014 in a city in China were reviewed, and classified into overweight/obese and control groups. All patients were followed to assess the occurrence of CAL by echocardiography for two months from disease onset. The independent effect of overweight/obesity on CAL was evaluated after adjustment for confounders. The interaction effect between overweight and laboratory indices was examined. The prevalence of overweight/obesity among KD patients was 18.5% (95%CI: 16.0%, 21.0%). The proportion of male patients and the proportion of non-standard IVIG treatment were significantly higher in overweight/obese children in comparison with their counterparts. Overweight/obesity was associated with increased odds of total CAL (aOR = 1.69, 95%CI: 1.16, 2.45) and also increased odds of CAL after treatment (aOR = 1.96, 95%CI: 1.09, 3.51); after adjustment for age, gender, KD type, change of medical departments, number of days before admission, treatment regimen and laboratory index. Similar results were found using stratification analysis. In addition, patients at risk of overweight were also associated with significantly increased risk of CAL. There was interaction between weight-for-height and platelet, WBC, and albumin.ConclusionsOverweight/obesity may be an independent risk factor for CAL among KD patients. Some laboratory indicators may modify this association.
Keywords:Overweight  Obesity  Coronary artery lesions  Kawasaki disease  Clinical epidemiology  CAL"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"coronary artery lesions  IVIG"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"intravenous immunoglobulin  KD"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"Kawasaki disease  PLT"}  {"#name":"keyword"  "$":{"id":"kwrd0070"}  "$$":[{"#name":"text"  "_":"platelet count  WBC"}  {"#name":"keyword"  "$":{"id":"kwrd0080"}  "$$":[{"#name":"text"  "_":"white blood cell count
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