Syndecan-1 Levels and Early Positive Fluid Balance Are Associated With Disease Severity in Acute Pancreatitis.

Autor:	Turunen A; From the Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki., Kuuliala K; Department of Bacteriology and Immunology, Helsinki University Hospital and University of Helsinki., Kuuliala A; Department of Bacteriology and Immunology, Helsinki University Hospital and University of Helsinki., Puolakkainen P; From the Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki., Kylänpää L; From the Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki., Hästbacka J, Lindström O; From the Abdominal Center, Department of Abdominal Surgery, Helsinki University Hospital and University of Helsinki.
Jazyk:	angličtina
Zdroj:	Pancreas [Pancreas] 2024 Oct 01; Vol. 53 (9), pp. e739-e747. Date of Electronic Publication: 2024 Apr 30.
DOI:	10.1097/MPA.0000000000002366
Abstrakt:	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.)
Databáze:	MEDLINE
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