{"title":"Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease.","authors":"Sohyun Kim, Lucy Youngmin Eun","doi":"10.3345/kjp.2018.06905","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Coronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA.</p><p><strong>Methods: </strong>This retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence (group 2) of CAA. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to collinearity between indicators of IDA, each indicator was paired with anemia in 3 models.</p><p><strong>Results: </strong>Serum iron, iron saturation, and ferritin concentration, the 3 indicators of IDA, were significantly higher in group 1 than in group 2. Three sets of models including anemia with iron indicators produced the OR of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The areas under the curve (AUCs) of ferritin concentration, iron saturation, serum iron, anemia, and Kobayashi score were 0.907 (95% CI, 0.851-0.963), 0.729 (95% CI, 0.648-0.810), 0.711 (95% CI, 0.629-0.793), 0.638 (95% CI, 0.545-0.731), and 0.563 (95% CI, 0.489-0.636), respectively.</p><p><strong>Conclusion: </strong>Indicators of IDA, especially ferritin, were highly associated with CAA; therefore, they were stronger predictors of CAA than Kobayashi scores. IDA indicators can be used to predict CAA development and to suggest requirements for early interventions.</p>","PeriodicalId":17863,"journal":{"name":"Korean Journal of Pediatrics","volume":"62 8","pages":"301-306"},"PeriodicalIF":0.0000,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/01/78/kjp-2018-06905.PMC6702116.pdf","citationCount":"6","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Korean Journal of Pediatrics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3345/kjp.2018.06905","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/2/8 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 6
Abstract
Purpose: Coronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA.
Methods: This retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence (group 2) of CAA. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a logistic regression model to estimate the association between CAA and other indicators. Due to collinearity between indicators of IDA, each indicator was paired with anemia in 3 models.
Results: Serum iron, iron saturation, and ferritin concentration, the 3 indicators of IDA, were significantly higher in group 1 than in group 2. Three sets of models including anemia with iron indicators produced the OR of CAA of 3.513, 3.171, and 2.256, respectively. The 3 indicators of IDA were negatively associated with CAA, by OR of 0.965, 0.914, and 0.944, respectively. The areas under the curve (AUCs) of ferritin concentration, iron saturation, serum iron, anemia, and Kobayashi score were 0.907 (95% CI, 0.851-0.963), 0.729 (95% CI, 0.648-0.810), 0.711 (95% CI, 0.629-0.793), 0.638 (95% CI, 0.545-0.731), and 0.563 (95% CI, 0.489-0.636), respectively.
Conclusion: Indicators of IDA, especially ferritin, were highly associated with CAA; therefore, they were stronger predictors of CAA than Kobayashi scores. IDA indicators can be used to predict CAA development and to suggest requirements for early interventions.
期刊介绍:
Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.