血清 syndecan-1 水平在儿童免疫球蛋白 A 血管炎患者中的变化。
Serum Syndecan-1 levels in patients with immunoglobulin A vasculitis in children.
机构信息
Gastrointestinal Lab, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, Zhejiang, China; Jinhua Hospital, Zhejiang University and Jinhua Municipal Central Hospital, Jinhua, China; Endoscopy center and Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, Zhejiang, China.
Gastrointestinal Lab, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, Zhejiang, China.
出版信息
J Pediatr (Rio J). 2022 Sep-Oct;98(5):526-532. doi: 10.1016/j.jped.2022.01.004. Epub 2022 Feb 28.
OBJECTIVE
The aim of this study was to evaluate the serum Syndecan-1 (SDC-1) levels in patients with immunoglobulin-A vasculitis (IgAV) in children and its relation with gastrointestinal involvements.
METHODS
Sixty-eight children with IgAV and 48 healthy children were enrolled in this cross-sectional study. Clinical and related laboratory data were collected from a computerized hospital database. Serum SDC-1 was collected on admission prior to treatment.
RESULTS
Forty-eight patients fully met the IgAV diagnostic criteria at admission (IgAV group), 20 patients with rash only and diagnosed IgAV during hospitalization (Purpura group). In IgAV group, 30 patients with gastrointestinal involvements (IgAV-GI group) and 18 patients without gastrointestinal involvements (IgAV-NGI group). SDC-1 serum levels were significantly higher in the IgAV group (86.37 ng/mL (IQR 59.16-117.14 ng/mL)) than in the controls (20.37 ng/mL (IQR 15.52-26.45 ng/mL)) and the Purpura group (32.66 ng/mL (IQR 14.87-49.89 ng/mL)). Additionally, SDC-1 (OR = 1.08) was independently associated with IgAV with a cut-off value (sensitivity and specificity) of 66.55 ng/mL (68.8%, 95.0%), and the area under the curve was 0.908. The serum SDC-1 levels of the IgAV-GI group (106.92 ± 50.12 ng/mL) were significantly higher than those in the IgAV-NGI group (67.52 ± 17.59 ng/mL). Logistic regression analysis showed that SDC-1 (OR = 1.03) was independently associated with IgAV-GI with a cut-off value of 89.39 ng/mL.
CONCLUSIONS
SDC-1 serum levels may mirror vascular endothelium injury and mucosal damage in IgAV. Its applicability as a surrogate biomarker in IgAV remains to be determined.
目的
本研究旨在评估儿童免疫球蛋白 A 血管炎（IgAV）患者的血清 Syndecan-1（SDC-1）水平及其与胃肠道受累的关系。
方法
本横断面研究纳入了 68 例 IgAV 患儿和 48 例健康儿童。从计算机化医院数据库中收集临床和相关实验室数据。在治疗前入院时采集血清 SDC-1。
结果
68 例患儿中，48 例完全符合 IgAV 诊断标准（IgAV 组），20 例患儿仅表现为皮疹，住院期间确诊为 IgAV（紫癜组）。在 IgAV 组中，30 例有胃肠道受累（IgAV-GI 组），18 例无胃肠道受累（IgAV-NGI 组）。与对照组（20.37ng/ml[IQR，15.52-26.45ng/ml]）和紫癜组（32.66ng/ml[IQR，14.87-49.89ng/ml]）相比，IgAV 组的血清 SDC-1 水平明显升高（86.37ng/ml[IQR，59.16-117.14ng/ml]）。此外，SDC-1（OR=1.08）与 IgAV 独立相关，截断值（灵敏度和特异性）为 66.55ng/ml（68.8%，95.0%），曲线下面积为 0.908。IgAV-GI 组（106.92±50.12ng/ml）的血清 SDC-1 水平明显高于 IgAV-NGI 组（67.52±17.59ng/ml）。Logistic 回归分析显示，SDC-1（OR=1.03）与 IgAV-GI 独立相关，截断值为 89.39ng/ml。
结论
血清 SDC-1 水平可能反映了 IgAV 中血管内皮损伤和黏膜损伤。其作为 IgAV 的替代生物标志物的适用性尚待确定。
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