Background Children with severe malarial anemia (SMA) typically have low in-hospital mortality but have a high risk of post-discharge readmission or death. We hypothesized that the dysregulation of hematopoiesis, vascular growth factors, and endothelial function that occurs in SMA might affect risk of readmission or death. Methods Plasma was obtained from children 18 months to 12 years old with SMA (N=145) in Kampala, Uganda on admission, and outcomes were assessed over 12-month follow-up. Admission plasma levels of ten biomarkers of vascular growth, hematopoiesis, and endothelial function were compared to risk of readmission or death over 12-month follow-up. Results Over 12-month follow-up, 19 of 145 children with SMA were either readmitted or died: 15 children were readmitted (13 with malaria) and 4 children died. In multivariable analyses adjusted for age and sex, elevated plasma levels of platelet-derived growth factor-BB (PDGF-BB) and vascular endothelial growth factor (VEGF) on admission were independently associated with a decreased risk of all-cause readmission or death (adjusted hazard ratios [95% confidence intervals], 0.28 [0.16-0.51] and 0.19 [0.08-0.48], respectively) and a decreased risk of readmission due to severe malaria (0.27 [0.15, 0.51] and 0.16 [0.05, 0.47]) but not with risk of uncomplicated malaria (1.01 [0.53, 1.95] and 2.07 [0.93-4.64]). Conclusions In children with severe malarial anemia, elevated plasma levels of PDGF-BB and VEGF, two factors that promote angiogenesis, are associated with a decreased risk of readmission or death in the year following admission, primarily driven by a decrease in the risk of recurrent severe malaria.

中文翻译：

---

PDGF-BB 和 VEGF 水平升高与严重疟疾性贫血儿童再入院或死亡风险降低相关


背景 患有严重疟疾性贫血 （SMA） 的儿童通常住院死亡率较低，但出院后再入院或死亡的风险较高。我们假设 SMA 中发生的造血、血管生长因子和内皮功能失调可能会影响再入院或死亡的风险。方法 在乌干达坎帕拉 18 个月至 12 岁的 SMA 儿童 （N=145） 入院时获取血浆，并在 12 个月的随访中评估结局。将血管生长、造血和内皮功能的 10 个生物标志物的入院血浆水平与 12 个月随访期间再入院或死亡的风险进行比较。结果 在 12 个月的随访中，145 名 SMA 患儿中有 19 名再次入院或死亡： 15 名儿童再次入院 （13 名患有疟疾），4 名儿童死亡。在针对年龄和性别调整的多变量分析中，入院时血小板衍生生长因子-BB （PDGF-BB） 和血管内皮生长因子 （VEGF） 血浆水平升高与全因再入院或死亡风险降低独立相关（校正风险比 [95% 置信区间]，分别为 0.28 [0.16-0.51] 和 0.19 [0.08-0.48]）和因严重疟疾再入院的风险降低（0.27 [0.15， 0.51] 和 0.16 [0.05， 0.47]），但没有无并发症疟疾的风险 （1.01 [0.53， 1.95] 和 2.07 [0.93-4.64]）。结论 在严重疟疾性贫血儿童中，PDGF-BB 和 VEGF 血浆水平升高是促进血管生成的两个因素，与入院后一年内再入院或死亡风险降低有关，这主要是由于复发性严重疟疾风险降低。