血清 syndecan1 有可能反映诊断时的活动，并预测抗中性粒细胞胞浆抗体相关性血管炎患者随访期间的死亡。
Serum syndecan1 has the potential to reflect activity at diagnosis and predict death during follow-up in patients with ANCA-associated vasculitis.
机构信息
Department of Medical Science, BK21 Plus Project, College of Medicine, Yonsei University, Seoul, Republic of Korea.
Division of Rheumatology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, Republic of Korea.
出版信息
Arthritis Res Ther. 2024 Sep 20;26(1):166. doi: 10.1186/s13075-024-03393-8.
OBJECTIVES
This study investigated whether serum syndecan1 at diagnosis reflects activity at diagnosis and predicts poor outcomes during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).
METHODS
The study included 79 patients with AAV from the cohort of Korean patients diagnosed with AAV. AAV-specific indices, including the Birmingham vasculitis activity score (BVAS), five-factor score (FFS), 36-item short-form survey (SF-36) physical and mental component summary (PCS and MCS), and vasculitis damage index (VDI), were assessed. Laboratory data including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also collected. The highest tertile and upper half of the BVAS were tentatively defined as having high AAV activity. Serum syndecan1 levels were measured in sera stored at diagnosis.
RESULTS
Serum syndecan1 at diagnosis was significantly correlated with AAV activity and functional status, as assessed by BVAS, FFS, SF-36 PCS, MCS, and acute-phase reactants, including ESR and CRP. Patients with serum syndecan1 ≥ 76.1 ng/mL at diagnosis, and those with serum syndecan1 ≥ 60.0 ng/mL at diagnosis showed significantly higher risks for the highest tertile and the upper half of BVAS at diagnosis than those without, respectively. Patients with serum syndecan1 ≥ 120.1 ng/mL at diagnosis had a significantly higher risk for all-cause mortality during follow-up than those without, and further, exhibited a significantly lower cumulative patients' survival rate than those without.
CONCLUSION
Serum syndecan1 at diagnosis may not only reflect AAV activity at diagnosis but may also be associated with all-cause mortality during follow-up.
目的
本研究旨在探讨抗中性粒细胞胞浆抗体（ANCA）相关性血管炎（AAV）患者诊断时的血清 syndecan1 是否反映诊断时的活动度，并预测随访期间的不良结局。
方法
本研究纳入了来自韩国 AAV 患者队列的 79 例 AAV 患者。评估了 AAV 特异性指标，包括伯明翰血管炎活动评分（BVAS）、五因子评分（FFS）、36 项简明健康调查量表（SF-36）生理和心理成分综合评分（PCS 和 MCS）以及血管炎损伤指数（VDI）。还收集了红细胞沉降率（ESR）和 C 反应蛋白（CRP）等实验室数据。暂定将 BVAS 的最高三分位数和上半部分定义为具有高 AAV 活性。在诊断时储存的血清中测量了血清 syndecan1 水平。
结果
诊断时的血清 syndecan1 与 AAV 活动度和功能状态显著相关，如 BVAS、FFS、SF-36 PCS、MCS 和急性期反应物（包括 ESR 和 CRP）评估。与诊断时血清 syndecan1<76.1ng/ml 的患者相比，诊断时血清 syndecan1≥76.1ng/ml 和≥60.0ng/ml 的患者分别具有更高的风险，分别为 BVAS 最高三分位数和上半部分。与诊断时血清 syndecan1<120.1ng/ml 的患者相比，诊断时血清 syndecan1≥120.1ng/ml 的患者在随访期间全因死亡率的风险显著更高，并且与诊断时血清 syndecan1<120.1ng/ml 的患者相比，患者的累积生存率显著更低。
结论
诊断时的血清 syndecan1 不仅可能反映诊断时的 AAV 活动度，而且可能与随访期间的全因死亡率相关。
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