A pilot study of increased gene expression of Growth Differentiation Factor 15 and Telomerase Reverse Transcriptase in the middle-aged with acute coronary artery disease

Abstract

Introduction: Growth Differentiation Factor 15 (GDF15) and Telomerase Reverse Transcriptase (TERT) may have roles as serum biomarkers of the pathophysiology of cardiovascular disease. We hypothesised altered genomic expression of the genes for these molecules in middle aged subjects with acute coronary artery disease. Method: Venous blood was obtained from 53 patients (27 with diabetes) presenting with an acute coronary syndrome and subsequently shown to have coronary artery disease (CAD), and from 46 age and sex matched controls free of cardiovascular disease and its risk factors. Relative expression of leukocyte transcriptome GAPDH, GDF15and TERT were determined by RT-PCR and quantified by quantitation-comparative Ct (ΔΔCt). Results: Compared to expression in controls, mean (95% confidence interval) relative expression of GDF15in the patients was 1.38 (1.13-1.49) (p<0.001), and of TERT was 1.12 (1.04-1.20) p=0.003), with relative expression of GDF15 being greater than that of TERT (p<0.001). Expression of the two genes failed to correlate significantly in the controls (r=0.22, p=0.131) but did so in the patients (r=0.55, p<0.01). There was no difference in relative expression of GDF15 in 26 patients free of diabetes (1.6 [1.42-1.78]) compared to those 27 with diabetes (1.6 [1.29-1.91]) (p=0.996). Similarly, there was no difference in the expression of TERT in patients free of diabetes (1.19 [1.06-1.33]) compared to those with diabetes (1.25 [0.98-1.50]) (p=0.739). Conclusion: Relative expression of GDF15 and TERTare both increased in middle-aged patients with CAD and in CAD+diabetes, with no difference between the patient groups. These genes may have roles in the pathogenesis of acute coronary artery disease.