Adipocytokine profile in children with Kawasaki disease at a mean follow-up period of 5.5 years: A study from North India

BACKGROUND Kawasaki disease(KD)is an acute self-limited vasculitis with a predilection for coronary arteries.Children with KD may have altered lipid metabolism and abnormal lipid profiles that may last for prolonged periods.However,there is a paucity of literature on the role of adipocytokines in KD.AIM To estimate the levels of adipocytokines(adiponectin,leptin and resistin)during the convalescent phase of KD.METHODS Twenty children,who had KD at least three years earlier,were enrolled in this study.In addition,20 healthy controls were also enrolled.Clinical and laboratory profiles of patients were obtained from hospital records.Serum adiponectin,leptin and resistin levels were estimated by enzyme-linked immunosorbent assay.RESULTS Mean age of the patients in the study group was 10.15±3 years and the male:female ratio was 1.5:1.Median serum resistin levels in patients with KD(27.77 ng/mL;[IQR:18.66,48.90])were decreased compared to controls(21.20 ng/mL;[IQR:14.80,27.00])(P=0.04).Median serum leptin levels in cases and controls were 1.83 ng/mL;(IQR:1.13,3.80),and 1.10 ng/mL;(IQR:0.41,2.88),respectively(P=0.09).Median serum adiponectin levels were similar in both cases(12.20μg/mL;[IQR:9.76,17.97])and controls(13.95μg/mL;[IQR:11.17,22.58]);(P=0.18).There was no significant difference in all 3 adipocytokines between children with(4/20)and without coronary artery abnormalities(16/20).CONCLUSION Serum resistin levels were significantly elevated in patients with KD during the convalescent phase compared to controls.Serum leptin levels appeared to be higher in patients with KD,although the difference was not statistically significant.Adiponectin levels were similar in both cases and controls.Raised resistin and leptin levels may partially explain lipid perturbations observed during the convalescent phase of KD.

Investigate Targeted Factors to Achieve Prediction Goal in Stroke Convalescence in Terms of Causal Relationships of Prediction Error

Background and Purpose: To investigate target functional independence measure (FIM) items to achieve the prediction goal in terms of the causal relationships between prognostic prediction error and FIM among stroke patients in the convalescent phase using the structural equation modeling (SEM) analysis. Methods: A total of 2992 stroke patients registered in the Japanese Rehabilitation Database were analyzed retrospectively. The prediction error was calculated based on a prognostic prediction formula proposed in a previous study. An exploratory factor analysis (EFA) then the factor was determined using confirmatory factorial analysis (CFA). Finally, multivariate analyses were performed using SEM analysis. Results: The fitted indices of the hypothesized model estimated based on EFA were confirmed by CFA. The factors estimated by EFA were applied, and interpreted as follows: “Transferring (T-factor),” “Dressing (D-factor),” and “Cognitive function (C-factor).” The fit of the structural model based on the three factors and prediction errors was supported by the SEM analysis. The effects of the D- and C-factors yielded similar causal relationships on prediction error. Meanwhile, the effects between the prediction error and the T-factor were low. Observed FIM items were related to their domains in the structural model, except for the dressing of the upper body and memory (p < 0.01). Conclusions: Transfer, which was not heavily considered in the previous prediction formula, was found in causal relationships with prediction error. It is suggested to intervene to transfer together with positive factors to recovery for achieving the prediction goal.