Objective: This systematic review aimed to evaluate the role of serum sortilin as a reliable biomarker for vascular stenosis or calcification, with a focus on its potential to predict cardiovascular morbidity and mortality. Background: Vascular calcification and stenosis are major contributors to cardiovascular disease, strongly linked to morbidity and mortality worldwide. Reliable biomarkers to promptly predict fatal outcomes are still lacking, as current diagnostic methods are often invasive or limited in sensitivity. Sortilin, a multifunctional membrane glycoprotein involved in lipoprotein metabolism and vascular remodeling, has emerged as a potential mediator linking dyslipidemia, inflammation, and atherogenesis. Studies suggest that elevated serum sortilin levels may contribute to endothelial dysfunction, vascular calcification, and plaque instability through enhanced low-density lipoprotein uptake and smooth muscle cell proliferation. key processes driving vascular and myocardial injury. Methods: We systematically searched databases such as PubMed, Embase, Medline, Cochrane Library, and Google Scholar to identify research papers investigating the association between serum sortilin levels and vascular calcification or stenosis. Eligible observational studies that were published between March 2017 to September 2025 were included. To eliminate risk of bias we performed quality assessment using the New Castle Ottawa scale. Results: Six observational studies encompassing 1,583 patients were analyzed. Multivariate logistic regression consistently identified elevated serum sortilin as a significant predictor of endothelial injury, vascular calcification, and stenosis. Receiver operating characteristic (ROC) analyses showed a significant association between higher sortilin levels and vascular dysfunction, while Pearson’s correlation and Kaplan–Meier survival curves further demonstrated its link with adverse vascular outcomes. Conclusion: The results demonstrated that elevated serum sortilin levels were significantly associated with vascular dysfunction and cardiovascular mortality, suggesting its potential as a novel biomarker for early detection and precise risk stratification. Further research is needed to elucidate this association.
Abuzayed et al. (Tue,) studied this question.