1. Syndecan-1 Levels and Early Positive Fluid Balance Are Associated With Disease Severity in Acute Pancreatitis.
- Author
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Turunen A, Kuuliala K, Kuuliala A, Puolakkainen P, Kylänpää L, Hästbacka J, and Lindström O
- Subjects
- Humans, Male, Female, Middle Aged, Aged, Adult, Acute Disease, Retrospective Studies, Biomarkers blood, Logistic Models, ROC Curve, APACHE, Glycocalyx metabolism, Enzyme-Linked Immunosorbent Assay, Multivariate Analysis, Syndecan-1 blood, Pancreatitis blood, Pancreatitis metabolism, Severity of Illness Index, Water-Electrolyte Balance, Heparitin Sulfate blood
- Abstract
Objective: The aim of the study is to study fluid balance and endothelial glycocalyx degradation, reflected by syndecan-1, and heparan sulfate (HS) levels, in early stages of acute pancreatitis (AP)., Materials and Methods: This study comprised of 210 AP patients (104 mild, 53 moderately severe, 17 severe). Blood was sampled within 72 hours from the onset of symptoms, and plasma syndecan-1 and HS levels were determined using ELISA. Fluid balance up to sampling and up to 4 days was determined retrospectively from medical records., Results: Syndecan-1 levels predicted severe AP (SAP) in receiver operating characteristic analysis [area under curve 0.699, 95% confidence interval (CI) 0.546 to 0.851, P = 0.021]. Increasing AP severity was associated with higher intravenous fluid intake and lower urine output. In multivariate binary logistic regression analysis, positive fluid balance up to sampling [odds ratio (OR) 1.05 per 100 ml, 95% CI 1.02 to 1.11, P = 0.010] and higher Acute Physiology and Chronic Health Evaluation II score at sampling (OR 1.48, 95% CI 1.20 to 1.83, P < 0.001) were independently associated with severe AP, while syndecan-1 level was not., Conclusions: SAP is associated with high positive fluid balance in the early stages of treatment. Although increased in SAP, syndecan-1 was not independently associated with SAP when controlling for fluid balance and Acute Physiology and Chronic Health Evaluation II score., Competing Interests: The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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