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.

Figure 1

Scatter plots of levels of each parameter over time in patients with serum SDC-1 levels of the prior day of < 16.67 ng/mL (red circle), 16.67–45.78 ng/mL (green triangle), 45.78–318.11 ng/mL (blue square) and < 318.11 ng/mL (purple cross).

Figure 2

Predicted value of each parameter over time in patients with serum SDC-1 levels of the day prior of 16.67 ng/mL (red line), 45.78 ng/mL (green line), and 318.11 ng/mL (blue line).