Serum syndecan-1 reflects organ dysfunction in critically ill patients

Abstract

Syndecan-1 (SDC-1) is found in the endothelial glycocalyx and shed into the blood during systemic inflammatory conditions. We investigated organ dysfunction associated with changing serum SDC-1 levels for early detection of organ dysfunction in critically ill patients. To evaluate the effect of SDC-1 on laboratory parameters measured the day after SDC-1 measurement with consideration for repeated measures, linear mixed effects models were constructed with each parameter as an outcome variable. A total of 94 patients were enrolled, and 831 samples were obtained. Analysis using mixed effects models for repeated measures with adjustment for age and sex showed that serum SDC-1 levels measured the day before significantly affected several outcomes, including aspartate aminotransferase (AST), alanine transaminase (ALT), creatinine (CRE), blood urea nitrogen (BUN), antithrombin III, fibrin degradation products, and D-dimer. Moreover, serum SDC-1 levels of the prior day significantly modified the effect between time and several outcomes, including AST, ALT, CRE, and BUN. Additionally, increasing serum SDC-1 level was a significant risk factor for mortality. Serum SDC-1 may be a useful biomarker for daily monitoring to detect early signs of kidney, liver and coagulation system dysfunction, and may be an important risk factor for mortality in critically ill patients.

Relationship Between Endothelial and Angiogenesis Biomarkers Envisage Mortality in a Prospective Cohort of COVID-19 Patients Requiring Respiratory Support

“…Elevation of the endothelial injury biomarkers, syndecan-1 and thrombomodulin (TM) in patients with sepsis is associated with intensive care unit (ICU) mortality ( 13 , 14 ). In COVID-19, reports of syndecan-1 increase are related to disease severity and have been suggested as an assessment of the clinical course of the patient ( 15 , 16 ).…”

Measuring the Concentration of Serum Syndecan-1 to Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

“…Although further studies are required, measuring the concentration of serum syndecan-1 may help assessing endothelial injury under low blood flow (e.g., chronic hemodiafiltration) and membrane compatibility by using a different type of dialyzer. Moreover, the serum syndecan-1 level is proposed to be a useful biomarker for daily monitoring of organ dysfunction, and may be an important risk factor for mortality in critically ill patients ( 25 ).…”

Measuring The Concentration of Serum Syndecan-1 To Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

“…Although further studies are required, measuring the concentration of serum syndecan-1 may help in the assessment of endothelial injury under low blood ow (e.g., chronic hemodia ltration), and of membrane compatibility by using a different type of dialyzer. Moreover, serum syndecan-1 is proposed to be a useful biomarker for daily monitoring of organ dysfunction, and may be an important risk factor for mortality in critically ill patients 25 .…”

“…Syndecan-1 is released from the endothelium when the glycocalyx is injured, causing an increase in its concentration in circulation 22 . Moreover, serum syndecan-1 has been used as an endothelial injury marker in recent clinical studies in critically ill patients [23][24][25][26] .…”