title: Reassessment of carotid intima-media thickness by standard deviation score in children and adolescents after Kawasaki disease.
abstract: Previous studies that used carotid ultrasound have been largely conflicting in regards to whether or not patients after Kawasaki disease (KD) have a greater carotid intima-media thickness (CIMT) than controls. To test the hypothesis that there are significant differences between the values of CIMT expressed as absolute values and standard deviation scores (SDS) in children and adolescents after KD and controls, we reviewed 12 published articles regarding CIMT on KD patients and controls. The mean ± SD of absolute CIMT (mm) in the KD patients and controls obtained from each article was transformed to SDS (CIMT-SDS) using age-specific reference values established by Jourdan et al. (J: n = 247) and our own data (N: n = 175), and the results among these 12 articles were compared between the two groups and the references for comparison of racial disparities. There were no significant differences in mean absolute CIMT and mean CIMT-SDS for J between KD patients and controls (0.46 ± 0.06 mm vs. 0.44 ± 0.04 mm, p = 0.133, and 1.80 ± 0.84 vs. 1.25 ± 0.12, p = 0.159, respectively). However, there were significant differences in mean CIMT-SDS for N between KD patients and controls (0.60 ± 0.71 vs. 0.01 ± 0.65, p = 0.042). When we assessed the nine articles on Asian subjects, the difference of CIMT-SDS between the two groups was invariably significant only for N (p = 0.015). Compared with the reference values, CIMT-SDS of controls was within the normal range at a rate of 41.6 % for J and 91.6 % for N. These results indicate that age- and race-specific reference values for CIMT are mandatory for performing accurate assessment of the vascular status in healthy children and adolescents, particularly in those after KD considered at increased long-term cardiovascular risk.
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan ; Noto Children's Clinic, 4-12-6 Heiwadai, Nerima-ku, Tokyo, 179-0083 Japan.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Noto
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kamiyama
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan.
authors.forename: Kensuke
authors.initials: K
authors.lastname: Karasawa
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Ayusawa
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, Tokyo, 173-8610 Japan.
authors.forename: Shori
authors.initials: S
authors.lastname: Takahashi
keywords: Carotid intima-media thickness (CIMT); Kawasaki disease (KD); Standard deviation score (SDS); Subclinical atherosclerosis