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A B S T R A C T Background Current therapeutic strategies for chronic obstructive pulmonary disease (COPD) remain insufficient to halt disease progression or prevent acute exacerbations. This study aimed to investigate vascular endothelial glycocalyx components (Syndecan-1, Heparan Sulfate, and Hyaluronic Acid) as biomarkers for detecting disease severity and predicting acute exacerbations (AECOPD). Methods 100 patients with COPD and 50 healthy volunteers from the Third Affiliated Hospital of Zhejiang Chinese Medical University. The serum glycocalyx (SDC-1, HS, and HA) levels of the subjects were detected, and the differences were compared. Results The level of SDC-1, HS, and HA were higher in the exacerbation group than in the stable group and the control group (P < 0.05), and in the stable group than in the control group (P < 0.05). SDC-1, HS, and HA were negatively correlated with PaO 2 , FVC% pred, FEV1% pred, and FEV1/FVC (P < 0.05) while positively correlating with PaCO 2 (P < 0.05). The logistic regression analysis showed that SDC-1, HS, and HA were influential factors in the acute exacerbation of COPD (AECOPD). The receiver operating characteristics analysis showed that SDC-1, HS, and HA had good predictive efficacy in the AECOPD. Strong correlations between hospital stay and levels of glycocalyx were evident, especially for SDC-1, HS, signifying robust associations with prolonged hospitalization. Conclusion The circulating levels of glycocalyx degradation products (SDC-1, HS, and HA) were markedly elevated in AECOPD patients and demonstrated significant correlations with the severity of impaired lung function and gas exchange. Analysis revealed that these biomarkers were independent predictors of acute exacerbations and strongly associated with prolonged hospitalization. Therefore, our study provides clinical evidence that quantifying these components offers a promising, non-invasive approach for assessing disease severity and predicting outcomes in COPD.
Yan et al. (Wed,) studied this question.