Predictive Value of monocyte to HCL-C ratio for Coronary Artery Lesion and Intravenous Immunoglobulin Resistance in Kawasaki Disease

Abstract Purpose We aimed to investigate the predictive validity of monocyte to high-density lipoprotein cholesterol ratio (MHR) for coronary artery lesions (CALs) and intravenous immunoglobulin (IVIG) resistance in Kawasaki disease (KD). Methods MHR values of a total of 207 KD patients were calculated and analyzed with regard to their clinical characteristics and outcomes. We compared the differences in clinical data and laboratory parameters between CAL + group and CAL- group as well as between IVIG-resistant group and IVIG-responsive group. Spearman correlation analysis was applied to evaluate the correlation between C-reactive protein (CRP) and MHR. Multivariate logistic regression was used to identify risk factors of CALs and IVIG resistance. Receiver operating characteristic (ROC) curve analysis was chosen to determine the optimal cutoff value of MHR and its validity in predicting CALs and IVIG resistance. Results The MHR level was significantly higher in CAL + group, with cut-off value of 1.30 g/L, yielding sensitivity of 0.753 and specificity of 0.805, as well as in IVIG-resistant group, with cut-off value of 1.03 g/L, yielding sensitivity of 0.97 and specificity of 0.485. Multivariate logistic regression showed that MHR was an independent risk factor for CALs but not for IVIG resistance. According to the Spearman correlation analysis, CRP was positively correlated with the MHR. Conclusions As a practical, cost-effective inflammatory biomarker, MHR has a significantly predictive value in KD children complicated with CALs and IVIG-resistance. Paying more attention to the changes of MHR in KD children may contribute to better understanding of KD development and prognosis in clinical practice.