Behnoush Amir Hossein, Khalaji Amirmohammad, Ghasemi Hoomaan, Tabatabaei Ghazaal Alavi, Samavarchitehrani Amirsaeed, Vaziri Zahra, Najafi Morvarid, Norouzi Mitra, Ghondaghsaz Elina, Amini Elahe, Gaudet Alexandre
School of Medicine Tehran University of Medical Sciences Tehran Iran.
Center for Orthopedic Trans-Disciplinary Applied Research Tehran University of Medical Sciences Tehran Iran.
Health Sci Rep. 2024 Sep 2;7(9):e70044. doi: 10.1002/hsr2.70044. eCollection 2024 Sep.
Endocan is a marker of endothelial damage. Data regarding the association of this proteoglycan and acute respiratory distress syndrome (ARDS) is discrepant. Hence, this study sought to investigate the possible correlation between serum/plasma endocan concentration and ARDS.
A systematic review and meta-analysis of international online databases was conducted following PRISMA guidelines. PubMed, SCOPUS, Embase, and Web of Science were searched in March 2023, with the leading search terms being "ARDS" OR "respiratory distress" AND "endocan" and other associated terms. Studies that measured endocan levels in patients with ARDS and compared it with non-ARDS controls or within different severities of ARDS were included. We performed a random-effect meta-analysis for pooling the differences using standardized mean difference (SMD) and 95% confidence interval (CI).
We included 14 studies involving 1,058 patients. Those developing ARDS had significantly higher levels of endocan compared to those without ARDS (SMD: 0.47, 95% CI: 0.10-0.84, = 0.01). Our meta-analysis of three studies found that endocan levels in ARDS nonsurvivors were significantly higher than in survivors (SMD: 0.31, 95% CI: 0.02-0.60, = 0.03). Three studies investigated endocan levels in different severities of ARDS. Only one of these studies reported significantly higher endocan levels in patients with worsening acute respiratory failure at Day 15. The other two reported no significant association between ARDS severity and circulating endocan levels.
Blood endocan levels were significantly higher in patients with ARDS than those without. Additionally, among patients with ARDS, blood endocan values were significantly elevated in nonsurvivors compared to survivors. These findings could help researchers design future studies and solidify these findings and finally, clinicians to take advantage of measuring endocan in clinical settings for assessment of patients with ARDS.
内脂素是内皮损伤的标志物。关于这种蛋白聚糖与急性呼吸窘迫综合征（ARDS）之间关联的数据存在差异。因此，本研究旨在探讨血清/血浆内脂素浓度与ARDS之间可能的相关性。
按照PRISMA指南对国际在线数据库进行系统评价和荟萃分析。于2023年3月检索了PubMed、SCOPUS、Embase和Web of Science，主要检索词为“ARDS”或“呼吸窘迫”以及“内脂素”和其他相关术语。纳入了测量ARDS患者内脂素水平并将其与非ARDS对照组或不同严重程度的ARDS患者进行比较的研究。我们使用标准化均数差（SMD）和95%置信区间（CI）进行随机效应荟萃分析以汇总差异。
我们纳入了14项研究，涉及1058例患者。与未发生ARDS的患者相比，发生ARDS的患者内脂素水平显著更高（SMD：0.47，95%CI：0.10 - 0.84，P = 0.01）。我们对三项研究的荟萃分析发现，ARDS非幸存者的内脂素水平显著高于幸存者（SMD：0.31，95%CI：0.02 - 0.60，P = 0.03）。三项研究调查了不同严重程度ARDS患者的内脂素水平。其中只有一项研究报告在第15天急性呼吸衰竭加重的患者中内脂素水平显著更高。另外两项研究报告ARDS严重程度与循环内脂素水平之间无显著关联。
ARDS患者的血液内脂素水平显著高于无ARDS的患者。此外，在ARDS患者中，非幸存者的血液内脂素值相比幸存者显著升高。这些发现有助于研究人员设计未来的研究并巩固这些发现，最终帮助临床医生在临床环境中利用测量内脂素评估ARDS患者。
