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A total of 180 subjects, including 80 KD patients, 70 febrile controls and 30 healthy controls were recruited. Serum of CHI3L1 were measured with an enzyme-linked immunosorbent assay. The correlation between CHI3L1 and clinical parameters was assessed by Spearman correlation coefficient. Multiple logistic regression was employed to investigate the association between CHI3L1 and the incidence of KD. The diagnostic power was evaluated with the receiver operating characteristic curve analysis. Serum CHI3L1 levels in the KD group were significantly higher than those in the fever control group and healthy group. Compared with fever patients, both patients with incomplete KD and complete KD had higher serum CHI3L1 levels. Serum CHI3L1 levels were positively associated with white blood cell counts, neutrophils, platelet, erythrocyte sedimentation rate, C-reactive protein, alanine aminotransferase and the incidence of KD, and negatively associated with hemoglobin, aspartate aminotransferase and albumin. High CHI3L1 tertiles was significantly associated with the high incidence of KD in the unadjusted or adjusted models. Analysis of the Receiver operating characteristic curves, it was showed that the area under the curve was 0.908, with sensitivity of 0.838 and specificity of 0.8 for continuous CHI3L1, and was 0.884 for categorical CHI3L1, with sensitivity of 0.938 and specificity of 0.643 to distinguish all types of KD, respectively. CHI3L1 had the AUC of 0.901, with sensitivity of 0.826 and specificity of 0.8, and had the area under curve of 0.952, with sensitivity of 0.818 and specificity of 0.971 to discriminate complete KD and incomplete KD from febrile diseases, respectively. Serum of CHI3L1 may be a novel and reliable biomarker for the diagnosis of KD.<\/jats:p>","DOI":"10.1038\/s41598-025-91935-8","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T07:13:22Z","timestamp":1741158802000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The association of serum CHI3L1 levels with the presence of Kawasaki disease"],"prefix":"10.1038","volume":"15","author":[{"given":"Jialin","family":"Zou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenjuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Duan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinghua","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"issue":"3","key":"91935_CR1","doi-asserted-by":"publisher","first-page":"238","DOI":"10.7499\/j.issn.1008-8830.2209127","volume":"25","author":"FY Jiao","year":"2023","unstructured":"Jiao, F. 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