Abstract：
Kawasaki disease (KD) is a self-limited febrile disease predominantly affecting infants and children under 5 years old. Coronary artery lesions (CAL) are a prevalent complication, highlighting the necessity for swift diagnosis and treatment. A comprehensive review of biomarkers applicable for the diagnosis and treatment of Kawasaki disease (KD) in clinical settings is imperative. To provide a comprehensive review and analysis of biomarkers for diagnosis of KD, incidence of CAL, and intravenous immunoglobulin (IVIG) resistance. The data included in our study were sourced from searches conducted in PubMed/MEDLINE, Embase, EBSCO, and Google Scholar until March 15, 2024. Studies investigating the association with KD or evaluating diagnostic value were included in our study. Eligibility was independently assessed by two authors, with conflicts resolved through discussion. Data extraction was performed by 2 independent authors, following Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guideline. Data were pooled using a random-effects model. We assess biomarkers relevant to KD, categorizing them into three groups: diagnostic, associated with CAL incidence, and linked to IVIG resistance. For studies focusing solely on association, we present standardized mean differences (SMD). For those reporting sensitivity and specificity as diagnostic measures, we calculate the diagnostic odds ratio (DOR) to compare their efficacy. We identified 14 meta-analyses on biomarkers related to KD. 11 biomarkers exhibited diagnostic value for KD, while 21 were associated with its progression. Four biomarkers, including non-coding RNAs (DOR, 19.35 [95% CI, 13.58-27.56]), Serum ferritin (DOR, 24.90 [11.67-53.12]), N terminal proBNP (DOR, 21.03 [9.03-49.00]), and micro RNAs (DOR, 45.28 [6.30-325.52]), have significant diagnostic value for the diagnosis of KD. Seven biomarkers showed significant association with the incidence of CAL. Twenty biomarkers were for the prediction of IVIG resistance, including prognostic nutritional index (DOR, 7.72 [95% CI, 2.37-25.09]), non-coding RNAs (DOR, 14.63 [3.24-66.14]), neutrophil to lymphocyte ratio (DOR, 6.62 [4.05-10.81]), platelet to lymphocyte ratio (DOR, 3.30 [2.10-5.19]), and C reactive protein (DOR, 6.58 [3.69-11.74]). Based on the evidence, we have proposed various biomarkers associated with KD. Our aim is for these biomarkers to have wide applicability in both diagnostic and therapeutic settings.
摘要：
川崎病（KD）是一种自限性发热疾病，主要影响5岁以下的婴儿和儿童。冠状动脉病变（CAL）是一种常见的并发症，强调快速诊断和治疗的必要性。在临床环境中，必须全面审查适用于川崎病（KD）诊断和治疗的生物标志物。为KD的诊断提供全面的生物标志物综述和分析,CAL的发生率，和静脉免疫球蛋白（IVIG）耐药性。我们研究中包含的数据来自PubMed/MEDLINE中进行的搜索，Embase,EBSCO,和谷歌学者，直到2024年3月15日。我们的研究包括调查与KD的相关性或评估诊断价值的研究。合格性由两位作者独立评估，通过讨论解决冲突。数据提取由2名独立作者进行，以下是流行病学观察性研究(MOOSE)指南的荟萃分析。使用随机效应模型汇集数据。我们评估与KD相关的生物标志物，将它们分为三组：诊断，与CAL发病率相关，并与IVIG抗性有关。对于仅关注关联的研究，我们提供标准化平均差异(SMD)。对于那些报告敏感性和特异性作为诊断措施的人，我们计算诊断比值比(DOR)以比较其疗效.我们确定了14个与KD相关的生物标志物的荟萃分析。11种生物标志物对KD具有诊断价值，而21与它的进展有关。四种生物标志物，包括非编码RNA(DOR，19.35[95%CI，13.58-27.56])，血清铁蛋白（DOR，24.90[11.67-53.12])，N末端proBNP（DOR，21.03[9.03-49.00]),和微小RNA(DOR，45.28[6.30-325.52]),对KD的诊断有显著的诊断价值。七个生物标志物显示与CAL的发病率显著相关。二十种生物标志物用于预测IVIG耐药性，包括预后营养指数(DOR，7.72[95%CI，2.37-25.09])，非编码RNA(DOR，14.63[3.24-66.14])，中性粒细胞与淋巴细胞比率（DOR，6.62[4.05-10.81]),血小板与淋巴细胞比率（DOR，3.30[2.10-5.19]),和C反应蛋白(DOR，6.58[3.69-11.74])。根据证据,我们已经提出了各种与KD相关的生物标志物。我们的目标是使这些生物标志物在诊断和治疗环境中具有广泛的适用性。
