GDF-15 for Prognostication of Cardiovascular and Cancer Morbidity and Mortality in Men

Abstract

The objective was to evaluate the hypothesis that growth-differentiation factor 15 (GDF-15) is an independent marker of the long-term risk for both cardiovascular disease and cancer morbidity beyond clinical and biochemical risk factors. Plasma obtained at age 71 was available from 940 subjects in the Uppsala Longitudinal Study of Adult Men (ULSAM) cohort. Complete mortality and morbidity data were obtained from public registries. At baseline there were independent associations between GDF-15 and current smoking, diabetes mellitus, biomarkers of cardiac (high-sensitivity troponin-T, NT-proBNP) and renal dysfunction (cystatin-C) and inflammatory activity (C-reactive protein), and previous cardiovascular disease (CVD). During 10 years follow-up there occurred 265 and 131 deaths, 115 and 46 cardiovascular deaths, and 185 and 86 events with coronary heart disease mortality or morbidity in the respective total cohort (n=940) and non-CVD (n=561) cohort. After adjustment for conventional cardiovascular risk factors, one SD increase in log GDF-15 were, in the respective total and non-CVD populations, associated with 48% (95%CI 26 to 73%, p<0.001) and 67% (95%CI 28 to 217%, p<0.001) incremental risk of cardiovascular mortality, 48% (95%CI 33 to 67%, p<0.001) and 61% (95%CI 38 to 89%, p<0.001) of total mortality and 36% (95%CI 19 to 56%, p<0.001) and 44% (95%CI 17 to 76%, p<0.001) of coronary heart disease morbidity and mortality. The corresponding incremental increase for cancer mortality in the respective total and non-cancer disease (n=882) population was 46% (95%CI 21 to 77%, p<0.001) and 38% (95%CI 12 to 70%, p<0.001) and for cancer morbidity and mortality in patients without previous cancer disease 30% (95%CI 12 to 51%, p<0.001). In conclusion, in elderly men, GDF-15 improves prognostication of both cardiovascular, cancer mortality and morbidity beyond established risk factors and biomarkers of cardiac, renal dysfunction and inflammation.

Growth Differentiation Factor 15 Predicts All-Cause Morbidity and Mortality in Stable Coronary Heart Disease

“…15 GDF-15 is also associated with increased risk of the composite of MI and death in the general population. [16][17][18] Furthermore, it is associated with both myocardial 16 and renal dysfunction. 19 Therefore, information on the GDF-15 level should preferably be used in multivariable clinical prediction models as one of several risk indicators when balancing the risk of bleeding and risk of ischemic events in patients on antithrombotic treatments.…”

Discovery of New Risk Markers for Ischemic Stroke Using a Novel Targeted Proteomics Chip

“…NT-pro-BNP, adrenomedullin, and GDF-15 have previously been suggested to be independent risk factors for stroke in the primary preventive setting in the community, 16,17 whereas ECP, IL-27-α, U-PAR, FAS, CSF-1, and MMP-7 are novel ischemic stroke risk markers.…”

Induction of Growth Differentiation Factor 15 in Skeletal Muscle of Old Taurine Transporter Knockout Mouse

“…Notably, serum GDF15 content correlates with the mortality rate in aging-related diseases in humans. [30][31][32][33] Future investigation is needed to determine whether the elevated GDF15 in the aged muscle is a therapeutic target to prevent aging-related anorexia, skeletal muscle loss and a various aging-related chronic diseases.…”