Syndecan-1 Levels and Early Positive Fluid Balance Are Associated With Disease Severity in Acute Pancreatitis
Turunen, Antti; Kuuliala, Krista; Kuuliala, Antti; Puolakkainen, Pauli; Kylänpää, Leena; Hästbacka, Johanna; Lindström, Outi (2024-10-01)
Turunen, Antti
Kuuliala, Krista
Kuuliala, Antti
Puolakkainen, Pauli
Kylänpää, Leena
Hästbacka, Johanna
Lindström, Outi
01.10.2024
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:tuni-202409258907
https://urn.fi/URN:NBN:fi:tuni-202409258907
Kuvaus
Peer reviewed
Tiivistelmä
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.
Kokoelmat
- TUNICRIS-julkaisut [19214]