Diagnostic and prognostic significance of serum taurine in spinal cord injury: A case–control study with prospective follow-up

ABSTRACT Background Spinal cord injury (SCI) causes significant neurological disability, with few reliable biochemical markers for diagnosis or prognosis. Taurine, a neuroprotective sulfur amino acid, shows promise in models but has limited clinical evidence. Objective To assess serum taurine levels in acute SCI, evaluate their diagnostic utility, and examine changes and predictors over six months. Methods In a case–control study with prospective follow-up, 200 acute traumatic SCI patients (100 paraplegia, 100 paraparesis) and 200 matched healthy controls were enrolled. Subsequently, serum taurine was measured by ELISA at baseline (within 24 hours) and again at 6 months. Analyses then included t-tests, ANOVA, ROC curves, and multivariable linear regression. Results SCI patients had lower baseline serum taurine than controls (180.17 ± 94.67 vs 843.72 ± 276.92 ng/mL, p < 0.0001) and at 6 months (370.61 ± 245.98 ng/mL, p < 0.0001). Taurine increased over time in SCI patients (p < 0.0001) but stayed below control values. Paraparesis patients had higher levels than paraplegia patients at both times. ROC analysis showed good diagnostic accuracy at baseline (cut-off ≤214.5 ng/mL; sensitivity 84.2%, specificity 81.5%; p < 0.001) and 6 months (AUC = 0.899; sensitivity 75.0%, specificity 94.5%). Regression identified injury severity and thoracic level as predictors at baseline (R 2 = 0.080, p = 0.012). At 6 months, injury severity, male gender, age, and thoracolumbar level were significant predictors (R 2 = 0.301, p < 0.001); BMI was not. Conclusion Serum taurine drops after acute SCI and partly recovers. Its diagnostic value and relation to injury support its use as a biomarker.