4.5 Article

AST-to-ALT ratio and coronary artery lesions among patients with Kawasaki disease

期刊

WORLD JOURNAL OF PEDIATRICS
卷 17, 期 6, 页码 659-668

出版社

ZHEJIANG UNIV PRESS
DOI: 10.1007/s12519-021-00479-0

关键词

Alanine aminotransferase; Aspartate aminotransferase; Coronary artery lesions; Kawasaki disease

资金

  1. National Natural Science Foundation of China [81870365, 81700439, 81801559]
  2. Gusu Health Personnel Training Project [GSWS2019048, 2020054]
  3. Suzhou Science and Technology Development Plan Project [SYS2019084, SS202066]
  4. Jiangsu Province Key Medical Young Talents [QNRC 2016765]

向作者/读者索取更多资源

The study found that a lower AST/ALT ratio was associated with an increased risk of CALs on admission, but not with the development of new CALs after intravenous immunoglobulin (IVIG) treatment.
Background The aim of this study was to explore the associations between the aspartate aminotransferase-to-alanine aminotransferase ratio (AST/ALT) and coronary artery lesions (CALs) among patients with Kawasaki disease (KD). Methods Medical records of KD patients presenting to a single center between January 2019 and December 2020 were retrospectively collected and analyzed. Univariate, multivariable-adjusted analyses, subgroup analyses, restricted cubic spline test, and fitted curves were used to evaluate the associations between AST/ALT and CALs. Results A total of 831 patients were enrolled, of which 201 (24.2%) had CALs on admission and 21 (2.5%) developed CALs de novo after intravenous immunoglobulin (IVIG). Multivariable-adjusted analyses models revealed that a lower AST/ALT was associated with an increased risk of CALs on admission when AST/ALT was a continuous variable (P = 0.007) and when it was a categorical variable (P for trend = 0.004). Each unit increase in AST/ALT was associated with a 22% lower risk of CALs on admission (odds ratio = 0.78, 95% confidence interval 0.65-0.94). A negative linear relationship was noted between AST/ALT and the risk of CALs on admission in both observed and fitted models. However, such associations were not observed in AST/ALT and CALs de novo after IVIG. None of the variables significantly modified the association between AST/ALT and CALs on admission and CALs de novo after IVIG (P > 0.05). Conclusion Our findings suggested that AST/ALT was a risk factor of CALs, but was not associated with progressive CALs.

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