Soluble endoglin as a biomarker of cardiovascular and metabolic disorders related to endothelial dysfunction: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Soluble endoglin (sENG) has been discussed as a biomarker of endothelial dysfunction, associated with cardiovascular and metabolic disorders. A critical evaluation of sENG as a diagnostic tool for atherosclerotic cardiovascular diseases (ASCVD), type 1 diabetes mellitus (DM1), type 2 diabetes mellitus (DM2), hypertensive disorders, and heart failure (HF) using a meta-analysis has never been performed.

METHODS

PUBMED, SCOPUS, and Web of Science databases were searched up to August 1, 2025. Information on sENG concentrations in the group with one of the above-mentioned diagnoses and the control group was extracted and analyzed. Publication bias and quality assessment were performed using the Newcastle-Ottawa Scale (NOS) criteria.

RESULTS

16 studies were evaluated. A total of 2113 subjects were included, comprising 1391 subjects in disease groups and 722 in the control group. sENG serum/plasma concentrations were significantly higher in disorders related to endothelial dysfunction than in controls, with a pooled mean difference of 0.92 ng/mL (95% CI: 0.50-1.34, p < 0.001). Additionally, sENG serum/plasma concentrations were significantly elevated in patients with DM1, 0.99 ng/mL (95% CI 0.45-1.54, p < 0.001), DM2, 1.98 ng/mL (95% CI 0.60-3.35, p = 0.005) and HF, 1.06 ng/mL (95% CI 0.06-2.06, p = 0.038), compared to controls.

CONCLUSIONS

This meta-analysis is the first to demonstrate that sENG serum/plasma concentrations are significantly higher in selected cardiovascular and metabolic disorders related to endothelial dysfunction. sENG might represent a novel biomarker reflecting endothelial damage only in patients with DM1, DM2, and heart failure.