Elevated endothelial dysfunction related biomarker levels indicate the severity and predict the incidence of sepsis

Abstract Background: The present study assessed to investigate the relationship between the serum endothelial dysfunction-related biomarker levels and the severity of organ dysfunction in septic patients. Methods: In total, 105 patients admitted to the Department of Critical Care Medicine were enrolled between September 2020 and November 2021. The levels of serum syndecan-1, soluble thrombomodulin(sTM) were measured by enzyme-linked immunosorbent assay (ELISA); Clinical and laboratory data were also recorded. Results: The enroll patient were divided into three groups: Infection group (n = 28), septic non-shock group (n = 31), and septic shock group (n = 46). Serum syndecan-1level (102.84 ± 16.53 vs. 55.38 ± 12.34 ng/mL), and sTM(6.60 ± 1.44 ng/mL vs. 5.23 ± 1.23 ng/mL, P < 0.01) in the septic group were clearly increased compared with the in infection group respectively. Besides, the serum syndecan-1 level was closely positively correlated with the serum sTM (rs = 0.712, r2 = 0.507, P < 0.001). Moreover, either serum syndecan-1(rs = 0.687, r2 = 0.472, P < 0.001) or sTM levels (rs = 0.6, r2 = 0.36, P < 0.01), was significantly positively correlated with the sequential organ failure assessment scores respectively. For the sepsis diagnosis, the results indicate Syndecan-1 (AUC 0.89 ± 0.04, P < 0.001) was more valuable for prediction than sTM (AUC 0.77 ± 0.06, P < 0.001). And for the septic shock diagnosis, the results indicate Syndecan-1 (AUC 0.95 ±0.02, P < 0.001) as the best predictor as well as SOFA score (AUC 0.95 ± 0.02, P < 0.001), compared with sTM (AUC 0.88 ± 0.03, P < 0.001).Conclusions: Serum syndecan-1, sTM levels were associated with the severity of organ dysfunction in septic patients, and serum syndecan-1, sTM levels were good for early identification of septic, particularly septic shock patients.