Serum Syndecan-1 Reflects Organ Dysfunction in Critically Ill Patients

Syndecan-1 (SDC-1) is found in the endothelial glycocalyx and shed into the blood during systemic inflammatory conditions. We examined organ dysfunction associated with changing serum SDC-1 levels in critically ill patients. A single-center, retrospective, observational study was conducted at Gifu University Hospital. Patients admitted to the intensive care unit from March 2019 to February 2020 were enrolled. 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 from the day before significantly modified the effect between time and several outcomes, including AST, ALT, CRE, and BUN. Serum SDC-1 may be a useful biomarker for daily monitoring of critically ill patients with kidney, liver and coagulation system injuries.