Dynamics of soluble syndecan-1 in maternal serum during and after pregnancies complicated by preeclampsia: a nested case control study

Lorenz Kuessel 1 , Heinrich Husslein 1 , Eliana Montanari 1 , Michael Kundi 2 , Gottfried Himmler 3 , Julia Binder 1 , Judith Schiefer 4  and Harald Zeisler 1
  • 1 Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
  • 2 Department of Environmental Health, Medical University of Vienna, Vienna, Austria
  • 3 The Antibody Lab GmbH, Vienna, Austria
  • 4 Department of Anaesthesiology, Intensive Care Medicine and Pain Management, Medical University of Vienna, Vienna, Austria
Lorenz Kuessel
  • Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
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, Heinrich Husslein
  • Corresponding author
  • Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
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, Eliana Montanari
  • Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
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, Michael Kundi, Gottfried Himmler, Julia Binder
  • Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
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, Judith Schiefer
  • Department of Anaesthesiology, Intensive Care Medicine and Pain Management, Medical University of Vienna, Vienna, Austria
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and Harald Zeisler
  • Department of Gynecology and Obstetrics, Medical University of Vienna, Vienna, Austria
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Abstract

Background

We investigated the dynamics and the predictive value of soluble syndecan-1 (Sdc-1), a biomarker of endothelial dysfunction, in uneventful pregnancies and pregnancies complicated by preeclampsia (PE).

Methods

Serum levels of Sdc-1 were measured at sequential time points during and after uneventful pregnancies (control, n = 95) and pregnancies developing PE (PE_long, n = 12). Levels were further measured in women with symptomatic PE (PE_state, n = 46) at a single time point.

Results

Sdc-1 levels increased consistently throughout pregnancy. In the PE_long group Sdc-1 levels were lower at all visits throughout pregnancy, and reached significance in weeks 18–22 (p = 0.019), 23–27 (p = 0.009), 28–32 (p = 0.006) and 33–36 (p = 0.008). After delivery, Sdc-1 levels dropped sharply in all pregnancies but were significantly elevated in the PE_long group. The predictive power of Sdc-1 was evaluated analyzing receiver operating characteristic (ROC) curves. A significant power was reached at weeks 14–17 (area under the curve [AUC] 0.65, p = 0.025), 23–27 (AUC 0.73, p = 0.004) and 33–36 (AUC 0.75, p = 0.013).

Conclusions

In summary, Sdc-1 levels were lower in women developing PE compared to uneventful pregnancies and Sdc-1 might be useful to predict PE. After delivery, Sdc-1 levels remained higher in women with PE. Additional studies investigating the link between glycocalyx degradation, Sdc-1 levels and placental and endothelial dysfunction in pregnancies affected by PE are warranted.

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Clinical Chemistry and Laboratory Medicine ( CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor of over three. CCLM is the official journal of nine national clinical societies and associated with EFLM.

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