Serum suPAR and SDC4 levels in patients with severe bronchial asthma and their relationship with lung function and prognosis

doi:10.3969/j.issn.1673-8640.2025.01.014

Abstract

Abstract:

Objective To investigate the relationship between serum levels of soluble urokinase plasminogen activator receptor（suPAR），syndecan-4（SDC4） and lung function and prognosis in patients with severe bronchial asthma. Methods A total of 102 patients with bronchial asthma in Xiantao First People's Hospital from October 2018 to March 2021 were enrolled and classified into severe asthma group（46 cases） and mild/moderate asthma group（56 cases），and 60 healthy subjects were enrolled as healthy control group. Serum suPAR，SDC4，tumor necrosis factor-alpha（TNF-α），interleukin-6（IL-6） and lung function indexes [forced expiratory volume in one second（FEV1），forced vital capacity（FVC），maximum mid-expiratory flow（MMEF）] were determined. FEV1/FVC% was calculated. The patients with severe bronchial asthma were followed up for 1 year and classified into good prognosis group（29 cases） and poor prognosis group（17 cases） according to whether they had recurrent asthma. Pearson correlation analysis was used to evaluate the correlation between indexes. Receiver operating characteristic（ROC） curve was used to evaluate the efficacy of serum suPAR and SDC4 in predicting the poor prognosis of patients with severe bronchial asthma. Results Serum suPAR，IL-6 and TNF-α levels in healthy control group，mild/moderate asthma group and severe asthma group were increased in turn（P<0.001），while serum SDC4 levels and FEV1，FEV1/FVC% and MMEF were decreased in turn（P<0.001）. Pearson correlation analysis showed that suPAR was positively correlated with IL-6 and TNF-α（P<0.05），it was negatively correlated with FEV1，FEV1/FVC% and MMEF in turn（P<0.001），and it was negatively correlated with SDC4 and IL-6，TNF-α（P<0.05）. It was positively correlated with FEV1，FEV1/FVC% and MMEF（P<0.001）. Compared with good prognosis group，the levels of suPAR，IL-6 and TNF-α in poor prognosis group were increased（P<0.001），and the levels of SDC4 were decreased（P<0.001）. The areas under curves（AUC） of serum suPAR and SDC4 single and combined determinations to determine the poor prognosis of patients with severe bronchial asthma were 0.886，0.875 and 0.949，respectively. Conclusions Serum suPAR and SDC4 levels are related to lung function in patients with severe bronchial asthma，and may be used as biomarkers for prognosis assessment in patients with severe bronchial asthma.

Key words: Soluble urokinase plasminogen activator receptor, Syndecan-4, Lung function, Severe bronchial asthma

CLC Number:

R446.1

LI Dezhong, WANG Zhiwei, XU Wenjuan, SHU Pinyuan. Serum suPAR and SDC4 levels in patients with severe bronchial asthma and their relationship with lung function and prognosis[J]. Laboratory Medicine, 2025, 40(1): 79-83.

Figures/Tables 5

References 22

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组别	例数	FEV1/L	FEV1/FVC%/%	MMEF/（L·s^-1）
正常对照组	60	5.82±0.79	93.69±11.08	4.14±0.72
轻/中症哮喘组	56	3.98±0.58^*	61.08±7.53^*	2.16±0.42^*
重症哮喘组	46	2.06±0.33^*#	54.62±6.86^*#	1.46±0.25^*#
F值		488.029	31.408	390.066
P值		<0.001	<0.001	<0.001
组别	suPAR/（ng·L^-1）	SDC4/（ng·mL^-1）	IL-6/（ng·L^-1）	TNF-α/（ng·L^-1）
正常对照组	6.52±1.62	8.11±1.28	7.56±1.34	37.82±5.67
轻/中症哮喘组	9.34±2.56^*	6.25±0.98^*	20.18±4.52^*	76.73±12.85^*
重症哮喘组	17.52±4.84^*#	5.43±0.62^*#	29.16±6.24^*#	96.42±15.86^*#
F值	166.676	97.626	334.187	342.528
P值	<0.001	<0.001	<0.001	<0.001

组别	例数	FEV1/L	FEV1/FVC%/%	MMEF/（L·s^-1）
正常对照组	60	5.82±0.79	93.69±11.08	4.14±0.72
轻/中症哮喘组	56	3.98±0.58^*	61.08±7.53^*	2.16±0.42^*
重症哮喘组	46	2.06±0.33^*#	54.62±6.86^*#	1.46±0.25^*#
F值		488.029	31.408	390.066
P值		<0.001	<0.001	<0.001
组别	suPAR/（ng·L^-1）	SDC4/（ng·mL^-1）	IL-6/（ng·L^-1）	TNF-α/（ng·L^-1）
正常对照组	6.52±1.62	8.11±1.28	7.56±1.34	37.82±5.67
轻/中症哮喘组	9.34±2.56^*	6.25±0.98^*	20.18±4.52^*	76.73±12.85^*
重症哮喘组	17.52±4.84^*#	5.43±0.62^*#	29.16±6.24^*#	96.42±15.86^*#
F值	166.676	97.626	334.187	342.528
P值	<0.001	<0.001	<0.001	<0.001

组别	例数	suPAR/（ng·L^-1）	SDC4/（ng·mL^-1）	IL-6/（ng·L^-1）	TNF-α/（ng·L^-1）
预后不良组	17	34.07±9.25	2.98±0.32	49.67±9.81	148.81±22.06
预后良好组	29	7.82±2.26	6.87±0.80	17.14±4.15	65.71±12.23
t值		14.660	19.101	15.710	16.491
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	suPAR/（ng·L^-1）	SDC4/（ng·mL^-1）	IL-6/（ng·L^-1）	TNF-α/（ng·L^-1）
预后不良组	17	34.07±9.25	2.98±0.32	49.67±9.81	148.81±22.06
预后良好组	29	7.82±2.26	6.87±0.80	17.14±4.15	65.71±12.23
t值		14.660	19.101	15.710	16.491
P值		<0.001	<0.001	<0.001	<0.001

项目	AUC（95%可信区间）	最佳临界值	敏感性/%	特异性/%	Youden指数
suPAR	0.886（0.784~0.989）	12.57 ng·L^-1	82.40	86.20	0.686
SDC4	0.875（0.774~0.976）	4.73 ng·mL^-1	86.20	82.40	0.686
联合检测	0.949（0.893~1.000）	0.43	82.40	89.70	0.721