Factors Enhancing Serum Syndecan-1 Concentrations: A Large-Scale Comprehensive Medical Examination

Abstract

Endothelial disorders are related to various diseases. An initial endothelial injury is characterized by endothelial glycocalyx injury. We aimed to evaluate endothelial glycocalyx injury by measuring serum syndecan-1 concentrations in patients during comprehensive medical examinations. A single-center, prospective, observational study was conducted at Asahi University Hospital. The participants enrolled in this study were 1313 patients who underwent comprehensive medical examinations at Asahi University Hospital from January 2018 to June 2018. One patient undergoing hemodialysis was excluded from the study. At enrollment, blood samples were obtained, and study personnel collected demographic and clinical data. No treatments or exposures were conducted except for standard medical examinations and blood sample collection. Laboratory data were obtained by the collection of blood samples at the time of study enrolment. According to nonlinear regression, the concentrations of serum syndecan-1 were significantly related to age (p = 0.016), aspartic aminotransferase concentration (AST, p = 0.020), blood urea nitrogen concentration (BUN, p = 0.013), triglyceride concentration (p < 0.001), and hematocrit (p = 0.006). These relationships were independent associations. Endothelial glycocalyx injury, which is reflected by serum syndecan-1 concentrations, is related to age, hematocrit, AST concentration, BUN concentration, and triglyceride concentration.

Vascular endothelial injury exacerbates coronavirus disease 2019: The role of endothelial glycocalyx protection

“…5,20,29 Several previous reports have suggested associations of endothelial glycocalyx injury with surgical invasion and severe diseases such as acute kidney injury, chronic kidney disease, and cardiovascular disease. [37][38][39][40] In addition, chronic conditions such as diabetes, 41 aging, 42 and hypertriglyceridemia 43 injure the structure of the endothelial glycocalyx and cause degradation. Consequently, patients with these conditions may be more susceptible to a rapid exacerbation of ARDS.…”

“…52 In fact, the latter parameter was used as an endothelial injury marker in a recent clinical study. 43,53 Hyaluronic acid, a component of the endothelial glycocalyx, has also been used as a marker of glycocalyx injury. 46 For now, early detection via a specific marker of injury remains the best means of endothelial glycocalyx protection and may enable the cure of an underlying disease.…”

Endothelial Glycocalyx Disorders May Be Associated With Extended Inflammation During Endotoxemia in a Diabetic Mouse Model

“…Several previous reports have suggested associations of endothelial glycocalyx injury with severe diseases, such as acute kidney injury, chronic kidney disease, sepsis, and cardiovascular disease ( Steppan et al, 2011 ; Padberg et al, 2014 ; Liborio et al, 2015 ; Neves et al, 2015 ). In addition, chronic conditions, such as diabetes ( Nieuwdorp et al, 2006a , b ; Broekhuizen et al, 2010 ), aging ( Machin et al, 2018 ), and hypertriglyceridemia ( Oda et al, 2019 ), injure the structure of the endothelial glycocalyx and cause degradation.…”

Serum Syndecan-1 Reflects Organ Dysfunction in Critically Ill Patients

“…Oda et al performed a retrospective observational study showing that AST and BUN were closely related to serum SDC-1 in 1313 patients who underwent comprehensive medical examinations. 19 Similarly, Johansson et al showed that serum SDC-1 was correlated with CRE (r = 0.34, P = 0.012) in septic patients who received noradrenaline. 23 Moreover, Puskarich et al reported that among patients with severe sepsis or septic shock, serum SDC-1 levels were signi cantly higher in patients with acute kidney injury (AKI) than in those without.…”

“…14 Serum syndecan-1 (SDC-1), the core protein in heparan sulfate proteoglycan, is found in the endothelial glycocalyx. In clinical research, serum SDC-1 has been used as an endothelial injury marker of several diseases, including chronic kidney disease, 15 diabetes, 16,17 cardiovascular disease, 18 hypertriglyceridemia 19 and sepsis. 20,21 Moreover, several indicators have demonstrated that serum SDC-1 levels are signi cantly correlated with the Sequential Organ Failure Assessment (SOFA) score in patients with sepsis, [22][23][24] and that non-survivors have signi cantly higher SDC-1 levels than survivors with sepsis.…”