title: Clinical Usefulness of Serum Krebs von den Lungen-6 for Detecting Chronic Aspiration in Children with Severe Motor and Intellectual Disabilities.
abstract: OBJECTIVE
  To determine whether the serum level of Krebs von den Lungen-6 (KL-6), a circulating high-molecular weight glycoprotein and a diagnostic biomarker of interstitial lung diseases, is a clinically useful biomarker for detecting chronic aspiration in children with severe motor and intellectual disabilities (SMIDS).
  
  
  METHODS
  Children with SMIDS undergoing videofluorography for assessment of dysphagia were prospectively evaluated. Based on the videofluorography results, the participants were classified into aspiration and non-aspiration groups. Age, sex, white blood cell count, and serum levels of C-reactive protein, lactate dehydrogenase, albumin, and KL-6 were compared between the 2 groups. Binary logistic regression was performed to identify factors independently associated with the presence of aspiration.
  
  
  RESULTS
  A total of 66 patients participated in this study, 37 who were classified as the aspiration group and 29 as the non-aspiration group. The serum KL-6 level in the aspiration group was significantly higher than that in the non-aspiration group (median, 344 U/mL vs 207 U/mL, P < .01). Logistic regression modeling showed that the number of prescribed antiepileptic drugs (OR, 1.978; 95% CI, 1.217, 3.214; P < .01) and serum KL-6 level (OR, 1.012; 95% CI, 1.005, 1.019; P < .01) were independent predictors of aspiration.
  
  
  CONCLUSIONS
  The study demonstrated that the KL-6 level is significantly higher in children with SMIDS who aspirate than in those who do not. KL-6 shows promise as a biomarker for chronic lung disease due to aspiration in these children.
authors.affiliation: Department of Pediatrics, Ehime Rehabilitation Center for Children, Ehime, Japan. Electronic address: wakamoto-hiroyuki@pref.ehime.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Wakamoto
authors.affiliation: Department of Pediatrics, National Hospital Organization Minami Kyushu Hospital, Kagoshima, Japan.
authors.forename: Nozomi
authors.initials: N
authors.lastname: Sano
authors.affiliation: Department of Pediatrics, National Hospital Organization Ehime Medical Center, Ehime, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Yano
authors.affiliation: Department of Radiology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Sakai
authors.affiliation: Department of Radiology, Ehime Prefectural Central Hospital, Ehime, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Kikuchi
authors.affiliation: Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Fukuda
authors.affiliation: Department of Pediatrics, Ehime Rehabilitation Center for Children, Ehime, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Department of Pediatrics, Ehime University Graduate School of Medicine, Ehime, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ishii
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008607:Intellectual Disability / Q000097:blood* / Q000175:diagnosis; D008297:Male; D018396:Mucin-1 / Q000097:blood*; D011015:Pneumonia, Aspiration / Q000097:blood* / Q000175:diagnosis; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1