Association Between Serum Syndecan 1 Levels and Metabolic Syndrome Parameters: A Comparative Cross-Sectional Study.

Previous studies have linked Syndecans (SDCs) to hypertension (HTN), BMI and the prevalence of coronary artery disease (CAD). The relationship between SDCs and metabolic syndrome (MetS) has not been explored. This study aimed to investigate the association between serum SDC1 level and MetS. This was a comparative cross-sectional study conducted on the subjects from phase II of the MASHAD study. A total of 81 subjects were divided into three groups: (1) healthy controls (N = 26), (2) subjects with MetS and hypertension with serum ALT < 43 U/L (MetS+ HTN+ ALT-), (N = 29), and (3) subjects with MetS and hypertension with serum ALT ≥ 43 U/L (MetS+ HTN+ ALT+), (N = 26). Serum SDC1 levels were measured using a commercial ELISA kit. Data were analysed using SPSS version 26 and R version 4.0.5 software. The analysis showed that mean serum SDC1 levels did not significantly differ between healthy and MetS+ groups overall. Among MetS+ subjects, males had significantly higher SDC1 levels than females (17.57 ± 8.48 vs. 12.85 ± 5.59 ng/mL, p = 0.018). In the MetS+ HTN+ ALT+ group, males also had higher SDC1 levels compared to females (20.19 ± 10.56 vs. 11.82 ± 5.09 ng/mL, p = 0.020), while no significant differences were observed across the MetS groups overall (p = 0.474). Additionally, in both the total study sample and the MetS+ HTN+ ALT+ group, SDC1 levels were positively correlated with diastolic blood pressure (DBP) (r = 0.256, p = 0.021; r = 0.463, p = 0.017, respectively), with no significant associations found with other metabolic parameters. These findings suggest that SDC1 levels are higher in males with MetS, particularly those with hypertension and elevated ALT, and are positively associated with DBP in both the total study sample and the MetS+ HTN+ ALT+ group. There were no significant associations with other metabolic parameters. This indicates that SDC1 may serve as a gender-specific biomarker for vascular risk in MetS, potentially aiding clinicians in identifying high-risk MetS subjects. © 2025 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.