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Nielsen RL, Bornæs O, Iversen E, Strejby Christensen LW, Kallemose T, Jawad B, Rasmussen HH, Munk T, Lund TM, Andersen O, Houlind MB, Leegaard Andersen A, Tavenier J. Growth differentiation factor 15 (GDF15) levels are associated with malnutrition in acutely admitted older adults. Clin Nutr 2024; 43:1685-1693. [PMID: 38879915 DOI: 10.1016/j.clnu.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND AND AIMS The aging process is often accompanied by high risk of malnutrition and elevated levels of growth differentiation factor 15 (GDF15). GDF15 is an increasingly recognized biomarker for regulation of metabolism, but few studies have investigated the connection between GDF15 and malnutrition in older age and how it relates to other features of aging such as decreased appetite and physical function. Therefore, we investigated the associations between GDF15 levels and nutritional status, appetite, and physical function in acutely admitted older adults. METHODS Plasma GDF15 levels were measured using immunoassays in 302 older adults (≥65 years) admitted to the emergency department (ED). Nutritional status was evaluated with the Mini Nutritional Assessment Short-Form (MNA®-SF), appetite was evaluated with the Simplified Nutritional Appetite Questionnaire (SNAQ), and physical function was evaluated with handgrip strength (HGS), 30-s chair stand test (30s-RSS), and gait speed (GS). Associations between GDF15 and each outcome was determined by logistic regression adjusted for age, sex, and C-reactive protein (CRP). RESULTS Each doubling in plasma GDF15 level was associated with an adjusted odds ratio (OR) (95% confidence interval) of 1.59 (1.10-2.29, P = 0.01) for risk of malnutrition compared to normal nutrition and 1.19 (0.85-1.69, P = 0.3)) for malnutrition compared to risk of malnutrition. Each doubling in GDF15 was associated with an adjusted OR of 1.63 (1.21-2.23)) for having poor appetite, 1.46 (1.07-1.99) for having low HGS, 1.74 (1.23-2.51) for having low 30s-RSS, and 1.99 (1.39-2.94) for having low GS. CONCLUSION Among older adults admitted to the ED, higher GDF15 levels were significantly associated with malnutrition, poor appetite, and low physical function independent of age, sex, and CRP.
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Affiliation(s)
- Rikke Lundsgaard Nielsen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Olivia Bornæs
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Esben Iversen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Louise Westberg Strejby Christensen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; The Capital Region Pharmacy, Marielundvej 25, 2730 Herlev, Denmark.
| | - Thomas Kallemose
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Baker Jawad
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark.
| | - Henrik Højgaard Rasmussen
- Center for Nutrition and Intestinal Failure, Aalborg University Hospital, Aalborg University, 9220 Aalborg, Denmark; The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital-Herlev and Gentofte, 2100 Copenhagen, Denmark.
| | - Tina Munk
- The Dietitians and Nutritional Research Unit, EATEN, Copenhagen University Hospital-Herlev and Gentofte, 2100 Copenhagen, Denmark.
| | - Trine Meldgaard Lund
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Emergency Department, Copenhagen University Hospital Amager and Hvidovre, 2650 Hvidovre, Denmark.
| | - Morten Baltzer Houlind
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark; The Capital Region Pharmacy, Marielundvej 25, 2730 Herlev, Denmark; Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100 Copenhagen Ø, Denmark.
| | - Aino Leegaard Andersen
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
| | - Juliette Tavenier
- Department of Clinical Research, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Allé 30, 2650 Hvidovre, Denmark.
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Lyu L, Xv C, Xu J, Liu Z, He Y, Zhu W, Lin L, Yang Q, Wei Y, Wang J, Huang T, Hao B, Liu H. Growth differentiation factor-15 predicts all-cause death and major adverse cardiovascular events in patients with coronary heart disease: a prospective cohort study. J Thromb Thrombolysis 2024:10.1007/s11239-024-03019-5. [PMID: 39068629 DOI: 10.1007/s11239-024-03019-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/03/2024] [Indexed: 07/30/2024]
Abstract
The prognostic value of growth differentiation factor-15 (GDF-15) in predicting long-term adverse outcomes in coronary heart disease (CHD) patients remains limited. Our study examines the association between GDF-15 and adverse outcomes over an extended period in CHD patients and firstly assesses the incremental prognostic effect of incorporating GDF-15 into the Framingham risk score (FRS)-based model. This single-center prospective cohort study included 3,321 patients with CHD categorized into 2,479 acute coronary syndrome (ACS) (74.6%) and 842 non-ACS (25.4%) groups. The median age was 61.0 years (range: 53.0-70.0), and 917 (27.6%) were females. Mortality and major adverse cardiovascular events (MACEs) included cardiovascular mortality, myocardial infarction (MI), stroke, and heart failure (HF) (inclusive of HF episodes requiring outpatient treatment and/or hospital admission). Cox regression models assessed the associations between GDF-15 and the incidence of all-cause mortality and MACEs. Patients were stratified into three groups based on GDF-15 levels: the first tertile group (< 1,370 ng/L), the second tertile group (1,370-2,556 ng/L), and the third tertile group (> 2,556 ng/L). The C-index, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA) were used to assess incremental value. Over a median 9.4-year follow-up, 759 patients (22.9%) died, and 1,291 (38.9%) experienced MACEs. The multivariate Cox model indicated that GDF-15 was significantly associated with all-cause mortality (per ln unit increase, HR = 1.49, 95% CI: 1.36-1.64) and MACEs (per ln unit increase, HR = 1.29, 95% CI: 1.20-1.38). These associations persisted when GDF-15 was analyzed as an ordinal variable (p for trend < 0.05). Subgroup analysis of ACS and non-ACS for the components of MACEs separately showed a significant association between GDF-15 and both cardiovascular mortality and HF, but no association was observed between GDF-15 and MI /stroke in both ACS and non-ACS patients. The addition of GDF-15 to the FRS-based model enhanced the discrimination for both all-cause mortality (∆ C-index = 0.009, 95% CI: 0.005-0.014; IDI = 0.030, 95% CI: 0.015-0.047; continuous NRI = 0.631, 95% CI: 0.569-0.652) and MACEs (∆ C-index = 0.009, 95% CI: 0.006-0.012; IDI = 0.026, 95% CI: 0.009-0.042; continuous NRI = 0.593, 95% CI: 0.478-0.682). DCA suggested that incorporating GDF-15 into the FRS-based model demonstrated higher net benefits compared to FRS-based models alone (All-cause mortality: FRS-based model: area under the curve of DCA (AUDC) = 0.0903, FRS-based model + GDF-15: AUDC = 0.0908; MACEs: FRS-based model: AUDC = 0.1806, FRS-based model + GDF-15: AUDC = 0.1833). GDF-15 significantly associates with the long-term prognosis of all-cause mortality and MACEs in CHD patients and significantly improves the prognostic accuracy of the FRS-based model for both outcomes.
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Affiliation(s)
- Lyu Lyu
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Cui Xv
- Department of Medical Administration, The 305 Hospital of PLA, Beijing, China
| | - Juan Xu
- Department of General Surgery, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China
| | - Zhenzhen Liu
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanru He
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wenjing Zhu
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lin Lin
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qiang Yang
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yun Wei
- Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jinda Wang
- Department of Cardiology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Taoke Huang
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Benchuan Hao
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China.
- Medical School of Chinese PLA, Beijing, China.
| | - Hongbin Liu
- Department of Cardiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China.
- Beijing Key Laboratory of Chronic Heart Failure Precision Medicine, Beijing, China.
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Beydoun MA, Noren Hooten N, Fanelli-Kuczmaski MT, Maino Vieytes CA, Georgescu MF, Beydoun HA, Freeman DW, Evans MK, Zonderman AB. Growth Differentiation Factor 15 and Diet Quality Trajectory Interact to Determine Frailty Incidence among Middle-Aged Urban Adults. J Nutr 2024; 154:1652-1664. [PMID: 38479650 PMCID: PMC11130674 DOI: 10.1016/j.tjnut.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Elevated plasma growth differentiation factor 15 (GDF15) and poor diet quality may be associated with increased frailty incidence, although their interactive associations have not been assessed in urban middle-aged adults. OBJECTIVES We aimed to examine GDF15 and its interactive association with diet quality in relation to frailty incidence among a sample of middle-aged urban adults. METHODS The relationship between GDF15 and diet quality trajectories in relation to incident frailty was examined in a longitudinal study of participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span (2004-2017). Serum GDF15 concentration and frailty incidence were primary exposure and outcome, respectively. Group-based trajectory models were used to assess diet quality trajectories (≤3 visits/participant, N = 945, N' = 2247 observations) using the Healthy Eating Index 2010 version (HEI-2010), Dietary Inflammatory Index, and mean adequacy ratio (MAR). Cox proportional hazards models were used, testing interactive associations of GDF15 and diet quality trajectories with frail/prefrail incidence (N = 400 frailty-free at first visit, N' = 604 observations, n = 168 incident frail/prefrail). RESULTS Both elevated GDF15 and lower diet quality trajectories were associated with a lower probability of remaining nonfrail (≤13 y follow-up). Among females, the "high diet quality" HEI-2010 trajectory had a hazard ratio (HR) of 0.15 [95% confidence interval (CI): 0.04, 0.54; P = 0.004; fully adjusted model] when compared with the "low diet quality" trajectory group. Among males only, there was an antagonistic interaction between lower HEI-2010 trajectory and elevated GDF15. Specifically, the HR for GDF15-frailty in the higher diet quality trajectory group (high/medium combined), and among males, was 2.69 (95% CI: 1.06, 6.62; P = 0.032), whereas among the lower diet quality trajectory group, the HR was 0.94 (95% CI: 0.49, 1.80; P = 0.86). Elevated GDF15 was independently associated with frailty among African American adults. CONCLUSIONS Pending replication, we found an antagonistic interaction between GDF15 and HEI-2010 trajectory in relation to frailty incidence among males.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, United States.
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, United States
| | | | | | - Michael F Georgescu
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, United States
| | - Hind A Beydoun
- VA National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs, Washington, DC, United States; Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - David W Freeman
- Department of Oncological Sciences, School of Medicine, University of Utah, Salt Lake City, UT, United States
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, United States
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, United States
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Boulet J, Sridhar VS, Bouabdallaoui N, Tardif JC, White M. Inflammation in heart failure: pathophysiology and therapeutic strategies. Inflamm Res 2024; 73:709-723. [PMID: 38546848 PMCID: PMC11058911 DOI: 10.1007/s00011-023-01845-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/09/2023] [Accepted: 12/19/2023] [Indexed: 04/30/2024] Open
Abstract
A role for inflammation in the development and progression of heart failure (HF) has been proposed for decades. Multiple studies have demonstrated the potential involvement of several groups of cytokines and chemokines in acute and chronic HF, though targeting these pathways in early therapeutic trials have produced mixed results. These studies served to highlight the complexity and nuances of how pro-inflammatory pathways contribute to the pathogenesis of HF. More recent investigations have highlighted how inflammation may play distinct roles based on HF syndrome phenotypes, findings that may guide the development of novel therapies. In this review, we propose a contemporary update on the role of inflammation mediated by the innate and adaptive immune systems with HF, highlighting differences that exist across the ejection fraction spectrum. This will specifically be looked at through the lens of established and novel biomarkers of inflammation. Subsequently, we review how improvements in inflammatory pathways may mediate clinical benefits of existing guideline-directed medical therapies for HF, as well as future therapies in the pipeline targeting HF and inflammation.
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Affiliation(s)
- Jacinthe Boulet
- Department of Medicine, Division of Cardiology, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Vikas S Sridhar
- Department of Medicine, Division of Nephrology, University Health Network, Toronto, ON, Canada
| | - Nadia Bouabdallaoui
- Department of Medicine, Division of Cardiology, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Jean-Claude Tardif
- Department of Medicine, Division of Cardiology, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada
| | - Michel White
- Department of Medicine, Division of Cardiology, Montreal Heart Institute, Université de Montréal, Montreal, QC, Canada.
- Department of Medicine, Division of Cardiology, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, QC, H1C 1C8, Montreal, Canada.
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Fukuda T, Yazawa H, Nishikawa R, Tokoi S, Kayashima R, Kono K, Sakuma M, Abe S, Toyoda S, Nakajima T. Physiological Role of Serum Growth Differentiation Factor-15 (GDF-15) Level and Iron Metabolism in Community-Dwelling Older Adults. Cureus 2024; 16:e60422. [PMID: 38883134 PMCID: PMC11179486 DOI: 10.7759/cureus.60422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/18/2024] Open
Abstract
Background Anemia is common in older adults and, together with heart failure and chronic kidney disease, forms a vicious cycle, whereas diseases such as chronic inflammation and cancer are associated with the anemia of chronic disease (ACD). Researchers have linked growth differentiation factor-15 (GDF-15) to a variety of conditions such as cardiovascular disease, inflammation, cancer, and kidney disease, and have reported hepcidin as a biomarker for iron regulation in ACD. Therefore, anemia, GDF-15, and hepcidin have significance in aging physiology. Hypothesis GDF-15 and hepcidin play important physiological roles in community-dwelling older adults. This study sought to explore the relationship between these biomarkers and anemia, inflammation, or other health outcomes. Methods This was a prospective study of 73 community-dwelling older adults (six men and 67 women, mean age of 76.3 years). Their serum iron level, percentage transferrin saturation (TSAT), high-sensitivity C-reactive protein (hs-CRP), and estimated glomerular filtration rate (eGFR) were measured. Enzyme-linked immunosorbent assays were used to assess their serum GDF-15, ferritin, and hepcidin levels. The participants' grip strength and walking speed were measured. The skeletal muscle mass index (SMI) of each participant was determined by bioelectrical impedance analysis. Results The GDF-15 level was significantly inversely correlated with serum iron, ferritin, and hepcidin levels; percentage TSAT; the eGFR; and gait speed. Serum hepcidin was positively correlated with levels of ferritin, albumin, and hemoglobin. Handgrip strength, SMI, and hs-CRP were not correlated with either GDF-15 or hepcidin levels. After adjusting for age, sex, and body mass index (BMI), multivariate analysis identified the log GDF-15 and serum iron level (log GDF-15: β=-0.248, iron: β=0.296) as significant factors determining hemoglobin levels, whose findings have significance due to novel results. Multivariate analysis identified eGFR and levels of hemoglobin and hepcidin as significant factors associated with log GDF-15 (eGFR: β=-0.406, hemoglobin: β=-0.269, hepcidin: β=-0.235). Similarly, ferritin and albumin levels were identified as significant factors associated with hepcidin levels (ferritin: β=0.590, Alb: β=0.277). Conclusions Anemia in community-dwelling older adults was determined not only by increasing serum iron levels but also by decreasing GDF-15 levels. Also, the increasing GDF-15 level was determined by a decreasing hepcidin level as well as the presence of anemia and renal dysfunction, and the decreasing hepcidin level was determined by decreasing stored iron and decreasing albumin levels. Serum GDF-15 and hepcidin could potentially inform diagnostic or treatment strategies for anemia or age-related health conditions.
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Affiliation(s)
- Taira Fukuda
- Department of Liberal Arts and Sciences, Kanagawa University of Human Services, Yokosuka, JPN
| | - Hiroko Yazawa
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, JPN
| | - Riichi Nishikawa
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, JPN
| | - Seiko Tokoi
- Department of Fundamental Nursing, Dokkyo Medical University School of Nursing, Mibu, JPN
| | - Ryo Kayashima
- Department of Fundamental Nursing, Dokkyo Medical University School of Nursing, Mibu, JPN
| | - Kaori Kono
- Department of Fundamental Nursing, Dokkyo Medical University School of Nursing, Mibu, JPN
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, JPN
| | - Shichiro Abe
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, JPN
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, JPN
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, JPN
- Department of Medical KAATSU Training, Dokkyo Medical University School of Medicine, Mibu, JPN
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You J, Guo Y, Zhang Y, Kang JJ, Wang LB, Feng JF, Cheng W, Yu JT. Plasma proteomic profiles predict individual future health risk. Nat Commun 2023; 14:7817. [PMID: 38016990 PMCID: PMC10684756 DOI: 10.1038/s41467-023-43575-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/13/2023] [Indexed: 11/30/2023] Open
Abstract
Developing a single-domain assay to identify individuals at high risk of future events is a priority for multi-disease and mortality prevention. By training a neural network, we developed a disease/mortality-specific proteomic risk score (ProRS) based on 1461 Olink plasma proteins measured in 52,006 UK Biobank participants. This integrative score markedly stratified the risk for 45 common conditions, including infectious, hematological, endocrine, psychiatric, neurological, sensory, circulatory, respiratory, digestive, cutaneous, musculoskeletal, and genitourinary diseases, cancers, and mortality. The discriminations witnessed high accuracies achieved by ProRS for 10 endpoints (e.g., cancer, dementia, and death), with C-indexes exceeding 0.80. Notably, ProRS produced much better or equivalent predictive performance than established clinical indicators for almost all endpoints. Incorporating clinical predictors with ProRS enhanced predictive power for most endpoints, but this combination only exhibited limited improvement when compared to ProRS alone. Some proteins, e.g., GDF15, exhibited important discriminative values for various diseases. We also showed that the good discriminative performance observed could be largely translated into practical clinical utility. Taken together, proteomic profiles may serve as a replacement for complex laboratory tests or clinical measures to refine the comprehensive risk assessments of multiple diseases and mortalities simultaneously. Our models were internally validated in the UK Biobank; thus, further independent external validations are necessary to confirm our findings before application in clinical settings.
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Affiliation(s)
- Jia You
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yu Guo
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Yi Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Ju-Jiao Kang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Lin-Bo Wang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China
| | - Jian-Feng Feng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
- Zhangjiang Fudan International Innovation Center, Shanghai, China.
- School of Data Science, Fudan University, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Zhejiang, China.
| | - Wei Cheng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Zhejiang, China.
- Shanghai Medical College and Zhongshan Hospital Immunotherapy Technology Transfer Center, Shanghai, China.
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, Institute of Science and Technology for Brain-Inspired Intelligence, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, China.
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7
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Pozo A, Rodríguez E, Calderón JM, Carratalá A, Sanchis J. Predictive Biochemical Model of Frailty and Mortality After Acute Myocardial Infarction. Am J Cardiol 2023; 205:283-289. [PMID: 37619495 DOI: 10.1016/j.amjcard.2023.07.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/24/2023] [Accepted: 07/30/2023] [Indexed: 08/26/2023]
Abstract
Frailty, characterized by reduced resistance to stressors, is associated with adverse outcomes in patients with myocardial infarction. The Fried score is commonly used to assess frailty but has several limitations. This study aimed to evaluate the relation between frailty and blood biomarkers and their predictive value for long-term mortality using a biochemical model. A total of 2 cohorts of elderly patients (>65 years old) hospitalized for acute coronary syndrome were included. Geriatric assessments and several blood biomarkers were measured. The predictive models for frailty were developed using logistic regression. The survival models were also developed using Cox regression. Among 466 patients, 9 biomarkers were significantly associated with frailty. Between these biomarkers, white blood cells count, hemoglobin, and fibrinogen showed the highest predictive power. Model 1, without growth differentiation factor 15 (GDF-15), showed a better accuracy in predicting the mortality than the Fried score. Model 2, with GDF-15, had a stronger correlation with frailty but had a lower predictive power for survival. Frailty is associated with dysregulation in the physiological systems and several biomarkers were linked to this fact in our study. However, the inclusion of GDF-15 did not significantly improve the model's predictive ability. Frailty assessment using blood biomarkers can provide valuable prognostic information in elderly patients with acute coronary syndrome.
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Affiliation(s)
- Adela Pozo
- Clinical Biochemistry Department, University Clinic Hospital of Valencia, Valencia, Spain.
| | - Enrique Rodríguez
- Clinical Biochemistry Department, University Clinic Hospital of Valencia, Valencia, Spain
| | - José M Calderón
- Cardiovascular and Renal Research Group, INCLIVA Research Institute, University of Valencia, Valencia, Spain
| | - Arturo Carratalá
- Clinical Biochemistry Department, University Clinic Hospital of Valencia, Valencia, Spain
| | - Juan Sanchis
- Department of Cardiology, University Clinic Hospital of Valencia. School of Medicine, University of Valencia, Valencia, Spain
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Wang J, Zhang T, Xu F, Gao W, Chen M, Zhu H, Xu J, Yin X, Pang J, Zhang S, Wei M, Chen J, Liu Y, Yu X, Chew DP, Chen Y. GDF-15 at admission predicts cardiovascular death, heart failure, and bleeding outcomes in patients with CAD. ESC Heart Fail 2023; 10:3123-3132. [PMID: 37620152 PMCID: PMC10567639 DOI: 10.1002/ehf2.14484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/01/2023] [Accepted: 07/04/2023] [Indexed: 08/26/2023] Open
Abstract
AIMS We aimed to investigate the independent associations between growth differentiation factor 15 (GDF-15) level at admission and cardiovascular (CV) death, thrombotic events, heart failure (HF), and bleeding outcomes in patients with coronary artery disease (CAD). METHODS AND RESULTS We measured the plasma concentrations of GDF-15 centrally in patients from the BIomarker-based Prognostic Assessment for patients with Stable angina and acute coronary Syndrome (BIPass) registry, which consecutively enrolled patients with CAD from November 2017 to September 2019 at five tertiary hospitals in China. The outcomes included CV death, thrombotic events [myocardial infarction (MI) and ischaemic stroke], HF events [acute HF during hospitalization and hospitalization for HF post-discharge (A/H HF) and cardiogenic shock], and bleeding outcomes [non-coronary artery bypass grafting-related major bleeding and clinically significant bleeding (CSB)] during the 12 month follow-up period after hospitalization. Among 6322 patients with CAD {65.4% male, median age 63.7 [inter-quartile range (IQR)] 56.0-70.1 years}, the median concentration of plasma GDF-15 at admission was 1091 (IQR 790.5-1635.0) ng/L. Higher concentrations of GDF-15 were associated with an increased risk of CV death [hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.35-2.88, P < 0.001], A/H HF (HR 2.69, 95% CI 1.92-3.77, P < 0.001), cardiogenic shock (HR 1.46, 95% CI 1.04-2.05, P = 0.029), and CSB (HR 1.48, 95% CI 1.22-1.79, P < 0.001), but not for MI or stroke, after adjusting for clinical risk factors and prognostic biomarkers. Adding GDF-15 to the model with risk factors and biomarkers improved the net reclassification for CV death, A/H HF, cardiogenic shock, and CSB. CONCLUSIONS In patients with CAD, admission levels of GDF-15 were associated with an increased 1 year risk of CV death, HF, and bleeding outcomes, but not with thrombotic events. GDF-15 may be a prognostic biomarker for CV death, HF, and bleeding outcomes and could be used to refine the risk assessment of these specific clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04044066.
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Affiliation(s)
- Jiali Wang
- Department of Emergency and Chest Pain CenterQilu Hospital of Shandong UniversityJinanChina
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of CardiologyQilu Hospital of Shandong UniversityJinanChina
| | - Tao Zhang
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Department of Biostatistics, School of Public Health, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Feng Xu
- Department of Emergency and Chest Pain CenterQilu Hospital of Shandong UniversityJinanChina
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of CardiologyQilu Hospital of Shandong UniversityJinanChina
| | - Wei Gao
- Department of CardiologyPeking University Third HospitalBeijingChina
| | - Ming Chen
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Huadong Zhu
- Department of Emergency, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Jun Xu
- Department of Emergency, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Xinxin Yin
- Department of Emergency and Chest Pain CenterQilu Hospital of Shandong UniversityJinanChina
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of CardiologyQilu Hospital of Shandong UniversityJinanChina
| | - Jiaojiao Pang
- Department of Emergency and Chest Pain CenterQilu Hospital of Shandong UniversityJinanChina
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of CardiologyQilu Hospital of Shandong UniversityJinanChina
| | - Song Zhang
- Department of Emergency and Chest Pain CenterQilu Hospital of Shandong UniversityJinanChina
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of CardiologyQilu Hospital of Shandong UniversityJinanChina
| | - Mengke Wei
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Department of Biostatistics, School of Public Health, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Jiahao Chen
- Department of Biostatistics, School of Public Health, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of MedicineShandong UniversityJinanChina
| | - Xuezhong Yu
- Department of Emergency, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingChina
| | - Derek P. Chew
- Department of Cardiovascular MedicineFlinders UniversityAdelaideAustralia
| | - Yuguo Chen
- Department of Emergency and Chest Pain CenterQilu Hospital of Shandong UniversityJinanChina
- Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceQilu Hospital of Shandong UniversityJinanChina
- Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education, Chinese National Health Commission and Chinese Academy of Medical Sciences, State and Shandong Province Joint Key Laboratory of Translational Cardiovascular Medicine, Department of CardiologyQilu Hospital of Shandong UniversityJinanChina
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9
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Fujita Y, Shinkai S, Taniguchi Y, Miura Y, Tanaka M, Ohsawa I, Kitamura A, Ito M. Association Between Serum GDF15 Concentration and Total Mortality in Community-Dwelling Japanese Older Populations: The Involvement of Renal Dysfunction. J Gerontol A Biol Sci Med Sci 2023; 78:1701-1707. [PMID: 37190783 DOI: 10.1093/gerona/glad105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Serum growth differentiation factor 15 (GDF15) is associated with age-related adverse outcomes. However, renal function has not been thoroughly evaluated in studies addressing the association between GDF15 and mortality. We aimed to clarify whether GDF15 is associated with total mortality after carefully controlling renal function markers. METHODS We divided 1 801 community-dwelling Japanese older adults into quartiles according to their serum GDF15 concentrations. The correlation of GDF15 with renal function and inflammation markers was assessed by calculating Spearman correlation coefficients. Cumulative survival rates of the quartiles were estimated. In a Cox regression analysis adjusted for confounders, the association between GDF15 and mortality was evaluated. The discriminative capacity of GDF15 for the prediction of mortality was assessed with receiver-operating characteristic analysis. RESULTS GDF15 was correlated with cystatin C (r = 0.394), β2-microglobulin (r = 0.382), C-reactive protein (r = 0.124), and interleukin-6 (r = 0.166). The highest GDF15 quartile showed poor survival compared to the others. Older adults with higher GDF15 were associated with an increased mortality risk, independent of demographics and clinically relevant variables (hazard ratio [95% confidence interval]: 1.98 [1.09-3.59]). This significant association disappeared when additionally adjusted for cystatin C (1.65 [0.89-3.05]) or β2-microglobulin (1.69 [0.91-3.12]). The ability to predict mortality was approximately comparable between GDF15 (area under the curve: 0.667), cystatin C (0.691), and β2-microglobulin (0.715). CONCLUSIONS Serum GDF15 is associated with total mortality in older Japanese after adjustment for major confounders. The increased mortality risk in older adults with higher GDF15 may be partly attributed to decreased renal function.
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Affiliation(s)
- Yasunori Fujita
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shoji Shinkai
- Graduate School of Nutrition and Health Science, Kagawa Nutrition University, Sakado, Saitama, Japan
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yu Taniguchi
- Japan Environment and Children's Study Programme Office, National Institute for Environmental Studies, Tsukuba, Ibaraki, Japan
| | - Yuri Miura
- Research Team for Mechanism of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Masashi Tanaka
- Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Ikuroh Ohsawa
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Akihiko Kitamura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
- Health Town Development Science Center, Yao City Health Center, Yao, Osaka, Japan
| | - Masafumi Ito
- Biological Process of Aging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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10
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Nopp S, Königsbrügge O, Schmaldienst S, Klauser-Braun R, Lorenz M, Pabinger I, Säemann M, Ay C. Growth differentiation factor-15 predicts major bleeding, major adverse cardiac events and mortality in patients with end-stage kidney disease on haemodialysis: findings from the VIVALDI study. Nephrol Dial Transplant 2023; 38:1836-1847. [PMID: 36472548 DOI: 10.1093/ndt/gfac321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Indexed: 08/01/2023] Open
Abstract
BACKGROUND Patients with end-stage kidney disease (ESKD) are at high risk of cardiovascular events and bleeding. Optimizing risk assessment of ESKD patients regarding the risk of thromboembolism and bleeding complications in comorbid conditions, including atrial fibrillation and coronary heart disease, is challenging. To improve risk prediction we investigated growth differentiation factor-15 (GDF-15), a promising cardiovascular biomarker, and its relation to adverse outcomes. METHODS In this prospective, multicentre, population-based cohort study, GDF-15 was measured in 594 ESKD patients on haemodialysis (median age 66 years, 38% female), who were followed up for a median of 3.5 years. The association of GDF-15 with major bleeding, arterial thromboembolism, major adverse cardiac events (MACE) and death was analysed within a competing risk framework. Further, we evaluated the additive predictive value of GDF-15 to cardiovascular and death risk assessment. RESULTS GDF-15 levels were in median 5475 ng/l (25th-75th percentile 3964-7533) and independently associated with major bleeding {subdistribution hazard ratio [SHR] 1.31 per double increase [95% confidence interval (CI) 1.00-1.71]}, MACE [SHR 1.47 (95% CI 1.11-1.94)] and all-cause mortality [SHR 1.58 (95% CI 1.28-1.95)] but not arterial thromboembolism [SHR 0.91 (95% CI 0.61-1.36)]. The addition of GDF-15 to the HAS-BLED score significantly improved discrimination and calibration for predicting major bleeding [C-statistics increased from 0.61 (95% CI 0.52-0.70) to 0.68 (95% CI 0.61-0.78)]. Furthermore, we established an additive predictive value of GDF-15 beyond current risk models for predicting MACE and death. CONCLUSION GDF-15 predicts the risk of major bleeding, cardiovascular events and death in ESKD patients on haemodialysis and might be a valuable marker to guide treatment decisions in this challenging patient population.
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Affiliation(s)
- Stephan Nopp
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Oliver Königsbrügge
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Ingrid Pabinger
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Marcus Säemann
- Department of Medicine VI, Clinic Ottakring, Vienna, Austria
| | - Cihan Ay
- Clinical Division of Hematology and Hemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
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11
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Mattia L, Gossiel F, Walsh JS, Eastell R. Effect of age and gender on serum growth differentiation factor 15 and its relationship to bone density and bone turnover. Bone Rep 2023; 18:101676. [PMID: 37090856 PMCID: PMC10113774 DOI: 10.1016/j.bonr.2023.101676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/03/2023] Open
Abstract
Senescent cells and senescence-associated secretory phenotype (SASP) proteins are involved in age-related bone loss. Growth differentiation factor 15 (GDF 15), a stress-responsive cytokine member of the transforming growth factor-β (TGF-β) superfamily, is one of the key SASP proteins. It is strongly associated with age and higher levels correlate with frailty and are detected in several conditions and diseases. It also modulates appetite and body weight through the binding to its receptor glial cell- derived neurotrophic factor family receptor alpha- like (GFRAL) in the brainstem. The GDF 15 involvement in bone metabolism has been studied in several murine models, however, it is still unclear in humans. Therefore, this study aims to determine whether GDF 15 is associated with bone mineral density (BMD) and bone turnover, and to establish the effect of age and gender on its levels. Serum GDF 15 was measured with an ELISA from R&D Systems in 180 healthy women and men from the "XtremeCT study", divided into three age groups which represent different stages of skeletal development (16-18, 30-32, over 70 years). We also measured bone resorption marker C-terminal telopeptide of type I collagen (CTX) and bone formation markers N-terminal propeptide of type I collagen (PINP), osteocalcin (OC) and bone alkaline phosphatase (BAP) using iSYS-IDS analyser. Parathyroid hormone (PTH), 25hydroxyvitamin D (25OH-vitamin D), Insulin-like Growth Factor I (IGF-1), estradiol and testosterone were measured using the Cobas automated analyser (Roche Diagnostics). We assessed BMD at spine and total hip by dual-energy x-ray absorptiometry (DXA) and high resolution peripheral quantitative computed tomography (HRpQCT) of the radius and tibia. Univariate analysis of variance with the post-hoc Sheffe test and multiple linear regression has been used to assess the effect of age and gender. Spearman's rank correlation was used to evaluate the associations between GDF 15 and the other variables. We found GDF 15 levels significantly associated with age (p < 0.001) and gender (p = 0.008), with a significant gender ∗ age interaction (p < 0.001). Significantly higher levels of GDF 15 were found in subjects aged over 70 compared with the younger people (p < 0.001) and significantly higher levels were detected in men. We did not find any significant correlation between GDF 15 and bone turnover markers (BTMs), BMD, HRpQCT measures and hormones in any of the age groups. In conclusion, age and gender are determinants of GDF15 and much higher levels are found in older people and in men. Since no association was found between GDF 15 and bone health measures, we hypothesize that the effect of GDF 15 on bone might be exert by other tissue, such as muscle.
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12
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Relationship Between Plasma Growth Differentiation Factor 15 Levels and Complications of Type 2 Diabetes Mellitus: A Cross-sectional Study. Can J Diabetes 2023; 47:117-123.e7. [PMID: 36526573 DOI: 10.1016/j.jcjd.2022.09.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 09/01/2022] [Accepted: 09/03/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Our aim in this study was to identify the associations between growth differentiation factor 15 (GDF15) and type 2 diabetes mellitus (T2DM) complications in a community-based population in China. METHODS Based on a cross-sectional study registered in the National Basic Public Health Service for disease management of Changshu in China, a total of 1,689 T2DM patients were enrolled and tested further for plasma GDF15 levels. Macrovascular (cardiovascular disease and diabetic foot) and microvascular (diabetic kidney disease [DKD], diabetic retinopathy, and neuropathy) complications were evaluated. Logistic regression models were conducted to identify the associations of GDF15 with the risk of diabetes complications, and linear regression models were used to assess relationships between GDF15 and other clinical features. RESULTS Overall, 459 of the 1,689 T2DM patients (27.18%) had complications. GDF15 levels were significantly higher in patients with any type of complication compared with their counterparts. With each standard deviation increase of base 10 logarithms of GDF15 (lg-GDF15), the risk of overall complications increased by 1.17-fold (95% confidence interval [CI], 1.03 to 1.32). In contrast to macrovascular complications, associations of GDF15 with microvascular complications appeared to be stronger (adjusted odds ratio [OR], 1.24; 95% CI, 1.08 to 1.43), especially for DKD (adjusted OR, 1.51; 95% CI, 1.19 to 1.93). Subgroup analyses showed that the strength of association between GDF15 and complications varied by distinct age and T2DM duration subgroups. Patients with 2 or more types of complications had higher levels of GDF15 than those with fewer types of complications. Also, linear relationships were identified between GDF15 and several liver and kidney function indices. CONCLUSION Higher GDF15 levels were associated with T2DM complications, especially DKD. GDF15 may serve as a biomarker for monitoring the deterioration of T2DM.
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deFilippi CR, Tran H, Gattani R, Daniels LB, Shah P, Ilkhanoff L, Christenson R, Lima JA, Seliger S. Association of cardiac troponin T and growth differentiation factor 15 with replacement and interstitial cardiac fibrosis in community dwelling adults: The multi-ethnic study of atherosclerosis. Front Cardiovasc Med 2023; 10:1104715. [PMID: 36844723 PMCID: PMC9949377 DOI: 10.3389/fcvm.2023.1104715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Background Subclinical abnormalities in myocardial structure (stage B heart failure) may be identified by cardiac and non-organ specific biomarkers. The associations of high-sensitivity cardiac troponin T (hs-cTnT) and growth differentiation factor-15 (GDF-15) with cardiac magnetic resonance imaging (CMR) interstitial fibrosis (extracellular volume [ECV]) is unknown and for GDF-15 the association with replacement (late gadolinium enhancement [LGE]) is also unknown. GDF-15 is a systemic biomarker also released by myocytes associated with fibrosis and inflammation. We sought to define the associations of hs-cTnT and GDF-15 with these CMR fibrosis measures in the MESA cohort. Methods We measured hs-cTnT and GDF-15 in MESA participants free of cardiovascular disease at exam 5. CMR measurements were complete in 1737 for LGE and 1258 for ECV assessment. We estimated the association of each biomarker with LGE and increased ECV (4th quartile) using logistic regression, adjusted for demographics and risk factors. Results Mean age of the participants was 68 ± 9 years. Unadjusted, both biomarkers were associated with LGE, but after adjustment only hs-cTnT concentrations remained significant (4th vs. 1st quartile OR] 7.5, 95% CI: 2.1, 26.6). For interstitial fibrosis both biomarkers were associated with 4th quartile ECV, but the association was attenuated compared to replacement fibrosis. After adjustment, only hs-cTnT concentrations remained significant (1st to 4th quartile OR 1.7, 95%CI: 1.1, 2.8). Conclusion Our findings identify that both interstitial and replacement fibrosis are associated with myocyte cell death/injury, but GDF-15 a non-organ specific biomarker prognostic for incident cardiovascular disease is not associated with preclinical evidence of cardiac fibrosis.
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Affiliation(s)
- Christopher R. deFilippi
- Inova Heart and Vascular Institute, Falls Church, VA, United States,*Correspondence: Christopher R. deFilippi,
| | - Henry Tran
- Inova Heart and Vascular Institute, Falls Church, VA, United States
| | - Raghav Gattani
- Inova Heart and Vascular Institute, Falls Church, VA, United States
| | - Lori B. Daniels
- Division of Cardiology, University of California and San Diego Medical Center, San Diego, CA, United States
| | - Palak Shah
- Inova Heart and Vascular Institute, Falls Church, VA, United States
| | | | - Robert Christenson
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Joao A. Lima
- The Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Stephen Seliger
- Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, United States
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14
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Sotos-Prieto M, Maroto-Rodriguez J, Ortolá R, Martinez-Gomez D, García-Esquinas E, Buño-Soto A, Rodríguez-Artalejo F. Association between a Mediterranean lifestyle and growth differentiation factor 15: The seniors ENRICA-2 cohort. Free Radic Biol Med 2023; 195:192-198. [PMID: 36584798 DOI: 10.1016/j.freeradbiomed.2022.12.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/22/2022] [Accepted: 12/24/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND Growth Differentiation Factor 15 (GDF-15) is a marker of inflammation and oxidative stress that has been associated with multiple age-related chronic diseases. Since lifestyle is key for preventing these adverse health outcomes, we examined the association between a Mediterranean lifestyle and GDF-15 serum concentrations in Spanish older adults. METHODS We used cross-sectional data from 2502 older adults participating in the Seniors ENRICA-2 cohort. Adherence to the Mediterranean lifestyle was assessed with the 27-item MEDLIFE index, divided into three blocks: 1) "Mediterranean food consumption, 2) Mediterranean dietary habits, 3) Physical activity, rest, social habits, and conviviality". Analyses of the association between the MEFLIFE index and GDF-15 concentrations were performed using multivariable linear regression models adjusting for the main potential confounders. RESULTS The MEDLIFE index was inversely associated with GDF-15. Compared with participants in the lowest quartile of the MEDLIFE score, GDF-15 mean percentage differences (95% CI) were -3.0% (-8.0, 2.3) for the second quartile, -8.7% (-13.0, -4.1) for the third quartile, and -10.1% (-15.0, -4.9) for the fourth quartile (p-trend<0.001). Block 3 of MEDLIFE, and particularly doing sufficient physical activity, adequate sleep duration, and participating in collective sports, was individually linked to lower concentrations of GDF-15. Results remained similar after excluding participants with cardiovascular disease, type 2 diabetes, or obesity. CONCLUSIONS A Mediterranean lifestyle was associated with reduced levels of GDF-15, suggesting that a combination of multiple lifestyles may be an integral approach to reduce chronic inflammation and disease burden in older adults.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue. Boston, Massachusetts, 02115, USA.
| | - Javier Maroto-Rodriguez
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain
| | - David Martinez-Gomez
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; Department of Chronic Disease, National Center of Epidemiology, Carlos III Health Institute, Calle de Sinesio Delgado 4, 28029, Madrid, Spain
| | - Antonio Buño-Soto
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Paseo de la Castellana, 261, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health. School of Medicine, Universidad Autónoma de Madrid, Calle del Arzobispo Morcillo, 4, 28029, Madrid, Spain; CIBERESP (CIBER of Epidemiology and Public Health), Av. Monforte de Lemos, 3-5, 28029, Madrid, Spain; IMDEA-Food Institute. CEI UAM+CSIC, Ctra. de Canto Blanco 8, E. 28049, Madrid, Spain
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15
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Beydoun MA, Noren Hooten N, Weiss J, Beydoun HA, Georgescu M, Freeman DW, Evans MK, Zonderman AB. GDF15 and its association with cognitive performance over time in a longitudinal study of middle-aged urban adults. Brain Behav Immun 2023; 108:340-349. [PMID: 36549580 PMCID: PMC10026559 DOI: 10.1016/j.bbi.2022.12.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/08/2022] [Accepted: 12/16/2022] [Indexed: 12/23/2022] Open
Abstract
Serum GDF15 levels are correlated with multiple neurodegenerative diseases. Few studies have tested this marker's association with middle-aged cognitive performance over time, and whether race affects this association is unknown. We examined associations of initial serum GDF15 concentrations with longitudinal cognitive performance, spanning domains of global mental status, visual and verbal memory, attention, fluency, and executive function in a sub-sample of adults participating in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 776, Agev1:30-66y, 45.6 % male, 57.0 % African American, 43.0 % below poverty). This analysis consisted of mixed-effects regression models applied to the total selected sample, while also stratifying the analyses by race in the main analyses and further stratifying by sex, age group and poverty status in an exploratory analysis. Our main findings, which passed multiple testing and covariate-adjustment, indicated that GDF15 was associated with poorer baseline performance on several cognitive tests, including animal fluency [overall sample: (Model 1: γ0 ± SE: -0.664 ± 0.208, P < 0.001; Model 2, γ0 ± SE: -0.498 ± 0.217, P < 0.05)]. Among White adults, GDF15 was linked to poorer performance on a brief test of attention (Model 1: γ0 ± SE: -0.426 ± 0.126, P < 0.001; Model 2, γ0 ± SE: -0.281 ± 0.139, P < 0.05); and Trailmaking test, part B (Model 1: γ0 ± SE: +0.129 ± 0.040, P < 0.001; Model 2, γ0 ± SE: +0.089 ± 0.041, P < 0.05), the latter being also linked to higher GDF15 among individuals living below poverty. Among women, GDF15 was associated with poor global mental status (Normalized MMSE: Model 1: γ0 ± SE: -2.617 ± 0.746, P < 0.001; Model 2: γ0 ± SE: -1.729 ± 0.709, P < 0.05). GDF15 was not associated with decline on any of the 11 cognitive test scores considered in ∼ 4 years of follow-up. In sum, we detected cross-sectional associations between GDF15 and cognition, although GDF15 did not predict rate of change in cognitive performance over time among a sample of middle-aged adults. More longitudinal studies are needed to address the clinical utility of this biomarker for early cognitive defects.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA.
| | - Nicole Noren Hooten
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Jordan Weiss
- Stanford Center on Longevity, Stanford University, Stanford, CA, USA
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, USA
| | - Michael Georgescu
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - David W Freeman
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA; Department of Oncological Sciences, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
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16
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Clement J, Yan Q, Agrawal M, Coronado RE, Sturges JA, Horvath M, Lu AT, Brooke RT, Horvath S. Umbilical cord plasma concentrate has beneficial effects on DNA methylation GrimAge and human clinical biomarkers. Aging Cell 2022; 21:e13696. [PMID: 36052758 PMCID: PMC9577957 DOI: 10.1111/acel.13696] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/16/2022] [Accepted: 07/04/2022] [Indexed: 01/25/2023] Open
Abstract
Plasma transfusions are standard treatments to replace missing proteins in people with rare genetic diseases. Prior studies have demonstrated that heterochronic parabiosis has beneficial effects on several tissues of old animals receiving young blood. Human clinical trials are currently underway to investigate whether the infusion of plasma or plasma-derived factors from young donors can be used to mitigate human age-related conditions. Here, we use data from a safety study (n = 18, mean age 74) to investigate whether human umbilical cord plasma concentrate (hereinafter Plasma Concentrate) injected weekly (1 ml intramuscular) into elderly human subjects over a 10-week period affects different biomarkers, including epigenetic age measures, standard clinical biomarkers of organ dysfunction, mitochondrial DNA copy number (mtDNA-CN), and leukocyte telomere length. This study shows that treatment with plasma concentrate is safe. More than 20 clinical biomarkers were significantly and beneficially altered following the treatments. For example, creatinine was significantly decreased (p = 0.0039), while estimated glomerular filtration rate (eGFR) was increased (p = 0.0044), indicating the treatment may improve biomarkers of kidney function. Three of four immunoglobulin biomarkers decreased, while telomere length and mtDNA-CN were not significantly affected by the treatment. The treatment reduced DNA methylation-based GrimAge by an average of 0.82 years (p = 0.0093), suggests a reduction in morbidity and mortality risk. By contrast, no significant results could be observed for epigenetic clocks that estimate chronological age. Our results support the view that plasma concentrate contains youth-promoting factors.
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Affiliation(s)
- James Clement
- Betterhumans Inc.GainesvilleFloridaUSA,Department of Chemical, Pharmaceutical and Agricultural SciencesUniversity of FerraraFerraraItaly
| | - Qi Yan
- Epigenetic Clock Development FoundationTorranceCaliforniaUSA
| | | | - Ramon E. Coronado
- Transplant Department, UT Health San AntonioSan AntonioTexasUSA,Department of Obstetrics and GynecologyBaylor College of MedicineHoustonTexasUSA,Signature BiologicsIrvingTexasUSA,Crown ScientificSan AntonioTexasUSA
| | | | - Markus Horvath
- Epigenetic Clock Development FoundationTorranceCaliforniaUSA
| | - Ake T. Lu
- Department of Human Genetics, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA,Altos LabsSan DiegoUSA
| | | | - Steve Horvath
- Department of Human Genetics, David Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA,Department of Biostatistics, Fielding School of Public HealthUniversity of CaliforniaLos AngelesCaliforniaUSA
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17
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Rodríguez-Ayala M, Banegas JR, Ortolá R, Gorostidi M, Donat-Vargas C, Rodríguez-Artalejo F, Guallar-Castillón P. Cooking methods are associated with inflammatory factors, renal function, and other hormones and nutritional biomarkers in older adults. Sci Rep 2022; 12:16483. [PMID: 36182963 PMCID: PMC9526743 DOI: 10.1038/s41598-022-19716-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/02/2022] [Indexed: 11/09/2022] Open
Abstract
Evidence of the role of cooking methods on inflammation and metabolic health is scarce due to the paucity of large-size studies. Our aim was to evaluate the association of cooking methods with inflammatory markers, renal function, and other hormones and nutritional biomarkers in a general population of older adults. In a cross sectional analysis with 2467 individuals aged ≥ 65, dietary and cooking information was collected using a validated face-to-face dietary history. Eight cooking methods were considered: raw, boiling, roasting, pan-frying, frying, toasting, sautéing, and stewing. Biomarkers were analyzed in a central laboratory following standard procedures. Marginal effects from generalized linear models were calculated and percentage differences (PD) of the multivariable-adjusted means of biomarkers between extreme sex-specific quintiles (Q) of cooking methods consumption were computed ([Q5 − Q1/Q1] × 100). Participants’ mean age was 71.6 years (53% women). Significant PD for the highest vs lowest quintile of raw food consumption was − 54.7% for high sensitivity-C reactive protein (hs-CRP), − 11.9% for neutrophils, − 11.9% for Growth Differentiation Factor-15, − 25.0% for Interleukin-6 (IL-6), − 12.3% for urinary albumin, and − 10.3% for uric acid. PD for boiling were − 17.8% for hs-CRP, − 12.4% for urinary albumin, and − 11.3% for thyroid-stimulating hormone. Concerning pan-frying, the PD was − 23.2% for hs-CRP, − 11.5% for IL-6, − 16.3% for urinary albumin and 10.9% for serum vitamin D. For frying, the PD was a 25.7% for hs-CRP, and − 12.6% for vitamin D. For toasting, corresponding figures were − 21.4% for hs-CRP, − 11.1% for IL-6 and 10.6% for vitamin D. For stewing, the PD was 13.3% for hs-CRP. Raw, boiling, pan-frying, and toasting were associated with healthy profiles as for inflammatory markers, renal function, thyroid hormones, and serum vitamin D. On the contrary, frying and, to a less extent, stewing showed unhealthier profiles. Cooking methods not including added fats where healthier than those with added fats heated at high temperatures or during longer periods of time.
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Affiliation(s)
- Montserrat Rodríguez-Ayala
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), 28029, Madrid, Spain.,Department of Microbiology and Parasitology, Hospital Universitario La Paz, 28046, Madrid, Spain
| | - José Ramón Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), 28029, Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), 28029, Madrid, Spain
| | - Manuel Gorostidi
- Department of Nephrology, Hospital Universitario Central de Asturias, Red de Investigación Renal (RedinRen), 33011, Oviedo, Spain
| | - Carolina Donat-Vargas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), 28029, Madrid, Spain.,ISGlobal, Campus Mar, 08036, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), 08002, Barcelona, Spain.,Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), 28029, Madrid, Spain.,IMDEA-Food Institute, CEI UAM+CSIC, 28049, Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid and CIBERESP (CIBER of Epidemiology and Public Health), 28029, Madrid, Spain. .,IMDEA-Food Institute, CEI UAM+CSIC, 28049, Madrid, Spain.
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18
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Nishikawa R, Fukuda T, Haruyama A, Shibasaki I, Yamaguchi S, Arikawa T, Obi S, Amano H, Yagi H, Sakuma M, Abe S, Fukuda H, Toyoda S, Nakajima T. Association between serum GDF-15, myostatin, and sarcopenia in cardiovascular surgery patients. IJC HEART & VASCULATURE 2022; 42:101114. [PMID: 36071948 PMCID: PMC9442355 DOI: 10.1016/j.ijcha.2022.101114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/11/2022] [Accepted: 08/24/2022] [Indexed: 11/26/2022]
Abstract
Background Myostatin is a negative regulator of skeletal muscle mass. On the other hand, growth differentiation factor (GDF)-15 is associated with lower muscle strength and muscle mass. We investigated the relationship between serum GDF-15, myostatin, and sarcopenia in patients receiving cardiovascular surgery through a ROC curve and a multivariate regression analysis. Methods Skeletal muscle mass index (SMI) by bioelectrical impedance analysis, hand-grip strength, knee extension strength, and walking speed were measured. Preoperative serum GDF-15 and myostatin levels were determined by ELISA. The sarcopenia index could be expressed as: −0.0042 × [myostatin] + 0.0007 × [GDF-15] + 0.0890 × age + 1.4030 × sex − 0.2679 × body mass index (BMI) − 2.1186. A ROC curve was plotted to identify the optimal cutoff level of the sarcopenia index to detect sarcopenia. Results 120 patients receiving cardiovascular surgery were included in the study. SMI, hand-grip strength, knee extension strength, and walking speed inversely correlated with GDF-15, but positively correlated with myostatin. In the multivariate stepwise regression analysis, SMI was a determinant of myostatin, and both GDF-15 and myostatin were determinants of SMI and muscle thickness, even after adjustment for age, sex, and BMI. A ROC curve showed that the sarcopenia index was a determinant of sarcopenia (cutoff value −1.0634, area under the curve 0.901, sensitivity 96.9%, specificity 70.9%). Conclusion GDF-15 and myostatin are associated with skeletal muscle volume in patients receiving cardiovascular surgery, but these associations are different. The sarcopenia index calculated from GDF-15 and myostatin levels may be a biomarker of sarcopenia.
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19
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Lemmelä S, Wigmore EM, Benner C, Havulinna AS, Ong RMY, Kempf T, Wollert KC, Blankenberg S, Zeller T, Peters JE, Salomaa V, Fritsch M, March R, Palotie A, Daly M, Butterworth AS, Kinnunen M, Paul DS, Matakidou A. Integrated analyses of growth differentiation factor-15 concentration and cardiometabolic diseases in humans. eLife 2022; 11:e76272. [PMID: 35916366 PMCID: PMC9391041 DOI: 10.7554/elife.76272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 08/01/2022] [Indexed: 02/02/2023] Open
Abstract
Growth differentiation factor-15 (GDF15) is a stress response cytokine that is elevated in several cardiometabolic diseases and has attracted interest as a potential therapeutic target. To further explore the association of GDF15 with human disease, we conducted a broad study into the phenotypic and genetic correlates of GDF15 concentration in up to 14,099 individuals. Assessment of 772 traits across 6610 participants in FINRISK identified associations of GDF15 concentration with a range of phenotypes including all-cause mortality, cardiometabolic disease, respiratory diseases and psychiatric disorders, as well as inflammatory markers. A meta-analysis of genome-wide association studies (GWAS) of GDF15 concentration across three different assay platforms (n=14,099) confirmed significant heterogeneity due to a common missense variant (rs1058587; p.H202D) in GDF15, potentially due to epitope-binding artefacts. After conditioning on rs1058587, statistical fine mapping identified four independent putative causal signals at the locus. Mendelian randomisation (MR) analysis found evidence of a causal relationship between GDF15 concentration and high-density lipoprotein (HDL) but not body mass index (BMI). Using reverse MR, we identified a potential causal association of BMI on GDF15 (IVW pFDR = 0.0040). Taken together, our data derived from human population cohorts do not support a role for moderately elevated GDF15 concentrations as a causal factor in human cardiometabolic disease but support its role as a biomarker of metabolic stress.
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Affiliation(s)
- Susanna Lemmelä
- Institute for Molecular Medicine Finland, University of HelsinkiHelsinkiFinland
| | | | - Christian Benner
- Institute for Molecular Medicine Finland, University of HelsinkiHelsinkiFinland
| | - Aki S Havulinna
- Institute for Molecular Medicine Finland, University of HelsinkiHelsinkiFinland
- Finnish Institute for Health and WelfareHelsinkiFinland
| | - Rachel MY Ong
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeCambridgeUnited Kingdom
| | - Tibor Kempf
- Department of Cardiology and Angiology, Hannover Medical SchoolHannoverGermany
| | - Kai C Wollert
- Department of Cardiology and Angiology, Hannover Medical SchoolHannoverGermany
| | - Stefan Blankenberg
- Clinic of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-EppendorfHamburgGermany
- Population Health Research Department, University Heart and Vascular Center, University Medical Center Hamburg-EppendorfHamburgGermany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/LuebeckHamburgGermany
| | - Tanja Zeller
- Clinic of Cardiology, University Heart and Vascular Center, University Medical Center Hamburg-EppendorfHamburgGermany
- German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/LuebeckHamburgGermany
- University Center of Cardiovascular Science, University Medical Center Hamburg-EppendorfHamburgGermany
| | - James E Peters
- Department of Immunology and Inflammation, Imperial College LondonLondonUnited Kingdom
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of CambridgeCambridgeUnited Kingdom
| | | | - Maria Fritsch
- Bioscience Renal, Research and Early Development Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZenecaGothenburgSweden
| | - Ruth March
- Precision Medicine, Oncology R&D, AstraZenecaCambridgeUnited Kingdom
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of HelsinkiHelsinkiFinland
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General HospitalBostonUnited States
- Program in Medical and Population Genetics, Broad Institute of MIT and HarvardCambridgeUnited States
| | - Mark Daly
- Institute for Molecular Medicine Finland, University of HelsinkiHelsinkiFinland
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General HospitalBostonUnited States
- Program in Medical and Population Genetics, Broad Institute of MIT and HarvardCambridgeUnited States
| | - Adam S Butterworth
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeCambridgeUnited Kingdom
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of CambridgeCambridgeUnited Kingdom
- British Heart Foundation Centre of Research Excellence, University of CambridgeCambridgeUnited Kingdom
- National Institute for Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of CambridgeCambridgeUnited Kingdom
| | - Mervi Kinnunen
- Institute for Molecular Medicine Finland, University of HelsinkiHelsinkiFinland
| | - Dirk S Paul
- Centre for Genomics Research, AstraZenecaCambridgeUnited Kingdom
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeCambridgeUnited Kingdom
- British Heart Foundation Centre of Research Excellence, University of CambridgeCambridgeUnited Kingdom
| | - Athena Matakidou
- Centre for Genomics Research, AstraZenecaCambridgeUnited Kingdom
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20
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Chen M, Ding N, Mok Y, Mathews L, Hoogeveen RC, Ballantyne CM, Chen LY, Coresh J, Matsushita K. Growth Differentiation Factor 15 and the Subsequent Risk of Atrial Fibrillation: The Atherosclerosis Risk in Communities Study. Clin Chem 2022; 68:1084-1093. [PMID: 35762561 DOI: 10.1093/clinchem/hvac096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/19/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is a stress-responsive biomarker associated with several types of cardiovascular diseases. However, conflicting results have been reported regarding its association with incident atrial fibrillation (AF) in the general population. METHODS In 10 234 White and Black Atherosclerosis Risk in Communities (ARIC) Study participants (mean age 60 years, 20.5% Blacks) free of AF at baseline (1993 to 1995), we quantified the association of GDF-15 with incident AF using Cox regression models. GDF-15 concentration was measured by an aptamer-based proteomic method. AF was defined as AF diagnosis by electrocardiogram at subsequent ARIC visits or AF diagnosis in hospitalization records or death certificates. Harrell's c-statistic and categorical net reclassification improvement were computed for risk discrimination and reclassification. RESULTS There were 2217 cases of incident AF over a median follow-up of 20.6 years (incidence rate 12.3 cases/1000 person-years). After adjusting for potential confounders, GDF-15 was independently associated with incident AF, with a hazard ratio (HR) of 1.42 (95% CI, 1.24-1.62) for the top vs bottom quartile. The result remained consistent (HR 1.23 [95% CI, 1.07-1.41]) even after further adjusting for 2 cardiac biomarkers, cardiac troponin T and natriuretic peptide. The results were largely consistent across demographic subgroups. The addition of GDF-15 modestly improved the c-statistic by 0.003 (95% CI, 0.001-0.006) beyond known risk factors of AF. CONCLUSIONS In this community-based biracial cohort, higher concentrations of GDF-15 were independently associated with incident AF, supporting its potential value as a clinical marker of AF risk.
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Affiliation(s)
- Mengkun Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Ning Ding
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Lena Mathews
- Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Ron C Hoogeveen
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Lin Yee Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.,Lillehei Heart Institute and Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD, USA
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21
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Ortolá R, García-Esquinas E, Buño-Soto A, Carballo-Casla A, Sotos-Prieto M, Banegas JR, Rodríguez-Artalejo F. Alcohol consumption patterns and growth differentiation factor 15 among life-time drinkers aged 65+ years in Spain: a cross-sectional study. Addiction 2022; 117:1647-1657. [PMID: 35072312 DOI: 10.1111/add.15809] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 01/10/2022] [Indexed: 12/18/2022]
Abstract
AIMS To examine the association of alcohol consumption patterns with growth differentiation factor 15 (GDF-15) in older drinkers, separately among individuals with cardiovascular disease (CVD)/diabetes and those without them, as GDF-15 is a strong biomarker of chronic disease burden. DESIGN Cross-sectional study. SETTING Population-based study in Madrid (Spain). PARTICIPANTS A total of 2051 life-time drinkers aged 65+ years included in the Seniors-ENRICA-2 study in 2015-17. Participants' mean age was 71.4 years and 55.4% were men. MEASUREMENTS According to their average life-time alcohol intake, participants were classified as occasional (≤ 1.43 g/day), low-risk (men: > 1.43-20 g/day; women: > 1.43-10 g/day), moderate-risk (men: > 20-40 g/day; women: > 10-20 g/day) and high-risk drinkers (men: > 40 g/day; women: > 20 g/day; or binge drinkers). We also ascertained wine preference (> 80% of alcohol derived from wine), drinking with meals and adherence to a Mediterranean drinking pattern (MDP) defined as low-risk drinking, wine preference and one of the following: drinking only with meals; higher adherence to the Mediterranean diet; or any of these. FINDINGS In participants without CVD/diabetes, GDF-15 increased by 0.27% [95% confidence interval (CI) = 0.06%, 0.48%] per 1 g/day increment in alcohol among high-risk drinkers, but there was no clear evidence of association in those with lower intakes or in the overall group, or across categories of alcohol consumption status. Conversely, among those with CVD/diabetes, GDF-15 rose by 0.19% (95% CI = 0.05%, 0.33%) per 1 g/day increment in the overall group and GDF-15 was 26.89% (95% CI = 12.93%, 42.58%) higher in high-risk versus low-risk drinkers. Drinking with meals did not appear to be related to GDF-15, but among those without CVD/diabetes, wine preference and adherence to the MDP were associated with lower GDF-15, especially when combined with high adherence to the Mediterranean diet. CONCLUSIONS Among older life-time drinkers in Madrid, Spain, high-risk drinking was positively associated with growth differentiation factor 15 (a biomarker of chronic disease burden). There was inconclusive evidence of a beneficial association for low-risk consumption.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Antonio Buño-Soto
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Adrián Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Environmental Health and Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM+CSIC, Madrid, Spain
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22
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Fukuda T, Nakajima T, Yazawa H, Hirose S, Yokomachi J, Kato T, Nishikawa R, Koshiji N, Tokura M, Nasuno T, Nishino S, Obi S, Shibasaki I, Kanaya T, Nakamura F, Fukuda H, Abe S, Sakuma M, Toyoda S. Relationship between the serum GDF-15 concentration and muscle function in female patients receiving aortic valve replacement (TAVR, SAVR): Comparison with healthy elderly female subjects. IJC HEART & VASCULATURE 2022; 40:101032. [PMID: 35495578 PMCID: PMC9043358 DOI: 10.1016/j.ijcha.2022.101032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/21/2022] [Accepted: 04/11/2022] [Indexed: 11/16/2022]
Abstract
Purpose Methods Results Conclusions
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Affiliation(s)
- Taira Fukuda
- Department of Liberal Arts and Human Development, Kanagawa University of Human Services, Yokosuka, Kanagawa 238-8522, Japan
- Corresponding author at: Department of Liberal Arts and Human Development, Kanagawa University of Human Services, 1-10-1 Heiseicho, Yokosuka, Kanagawa 238-8522, Japan.
| | - Toshiaki Nakajima
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Hiroko Yazawa
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Suguru Hirose
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Jun Yokomachi
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Takashi Kato
- Department of Cardiovascular Surgery, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Riichi Nishikawa
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Nobuo Koshiji
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Michiaki Tokura
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Takahisa Nasuno
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Setsu Nishino
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Syotaro Obi
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Ikuko Shibasaki
- Department of Cardiovascular Surgery, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Tomoaki Kanaya
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Fumitaka Nakamura
- Third Department of Internal Medicine, Teikyo University, Chiba Medical Center, Ichihara, Chiba 299-0111, Japan
| | - Hirotsugu Fukuda
- Department of Cardiovascular Surgery, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Shichiro Abe
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
| | - Shigeru Toyoda
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan
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23
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Omran F, Kyrou I, Osman F, Lim VG, Randeva HS, Chatha K. Cardiovascular Biomarkers: Lessons of the Past and Prospects for the Future. Int J Mol Sci 2022; 23:ijms23105680. [PMID: 35628490 PMCID: PMC9143441 DOI: 10.3390/ijms23105680] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 12/12/2022] Open
Abstract
Cardiovascular diseases (CVDs) are a major healthcare burden on the population worldwide. Early detection of this disease is important in prevention and treatment to minimise morbidity and mortality. Biomarkers are a critical tool to either diagnose, screen, or provide prognostic information for pathological conditions. This review discusses the historical cardiac biomarkers used to detect these conditions, discussing their application and their limitations. Identification of new biomarkers have since replaced these and are now in use in routine clinical practice, but still do not detect all disease. Future cardiac biomarkers are showing promise in early studies, but further studies are required to show their value in improving detection of CVD above the current biomarkers. Additionally, the analytical platforms that would allow them to be adopted in healthcare are yet to be established. There is also the need to identify whether these biomarkers can be used for diagnostic, prognostic, or screening purposes, which will impact their implementation in routine clinical practice.
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Affiliation(s)
- Farah Omran
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Clinical Sciences Research Laboratories, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX, UK
| | - Ioannis Kyrou
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre of Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry CV1 5FB, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Faizel Osman
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Ven Gee Lim
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Department of Cardiology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Harpal Singh Randeva
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Clinical Sciences Research Laboratories, University Hospitals Coventry and Warwickshire, Coventry CV2 2DX, UK
| | - Kamaljit Chatha
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; (F.O.); (I.K.); (F.O.); (V.G.L.); (H.S.R.)
- Biochemistry and Immunology Department, University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Correspondence:
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24
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Xu G, Chen J, Jo S, Grayson TB, Ramanadham S, Koizumi A, Germain-Lee EL, Lee SJ, Shalev A. Deletion of Gdf15 Reduces ER Stress-induced Beta-cell Apoptosis and Diabetes. Endocrinology 2022; 163:6548945. [PMID: 35290443 PMCID: PMC9272264 DOI: 10.1210/endocr/bqac030] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Indexed: 01/12/2023]
Abstract
Endoplasmic reticulum (ER) stress contributes to pancreatic beta-cell apoptosis in diabetes, but the factors involved are still not fully elucidated. Growth differentiation factor 15 (GDF15) is a stress response gene and has been reported to be increased and play an important role in various diseases. However, the role of GDF15 in beta cells in the context of ER stress and diabetes is still unclear. In this study, we have discovered that GDF15 promotes ER stress-induced beta-cell apoptosis and that downregulation of GDF15 has beneficial effects on beta-cell survival in diabetes. Specifically, we found that GDF15 is induced by ER stress in beta cells and human islets, and that the transcription factor C/EBPβ is involved in this process. Interestingly, ER stress-induced apoptosis was significantly reduced in INS-1 cells with Gdf15 knockdown and in isolated Gdf15 knockout mouse islets. In vivo, we found that Gdf15 deletion attenuates streptozotocin-induced diabetes by preserving beta cells and insulin levels. Moreover, deletion of Gdf15 significantly delayed diabetes development in spontaneous ER stress-prone Akita mice. Thus, our findings suggest that GDF15 contributes to ER stress-induced beta-cell apoptosis and that inhibition of GDF15 may represent a novel strategy to promote beta-cell survival and treat diabetes.
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Affiliation(s)
- Guanlan Xu
- Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Correspondence: Guanlan Xu, PhD, Comprehensive Diabetes Center, University of Alabama at Birmingham, 1825 University Blvd, Shelby Bldg 1272, Birmingham, AL 35294-2182, USA. E-mail:
| | - Junqin Chen
- Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - SeongHo Jo
- Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Truman B Grayson
- Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Sasanka Ramanadham
- Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Akio Koizumi
- Institute of Public Health and Social Welfare Public Interest Incorporation Associations, Kyoto Hokenkai, Ukyo-ku Kyoto 615-8577, Japan
| | - Emily L Germain-Lee
- Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT 06030, USA
- Connecticut Children’s Center for Rare Bone Disorders, Farmington, CT 06032, USA
| | - Se-Jin Lee
- The Jackson Laboratory for Genomic Medicine, Farmington, CT 06032, USA
- University of Connecticut School of Medicine, Department of Genetics and Genome Sciences, Farmington, CT 06030, USA
| | - Anath Shalev
- Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA
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25
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Ortolá R, García-Esquinas E, Buño-Soto A, Cabanas-Sánchez V, Martínez-Gómez D, Sotos-Prieto M, Struijk EA, Caballero FF, Lopez-Garcia E, Banegas JR, Rodríguez-Artalejo F. Associations of device-measured sleep, sedentariness and physical activity with growth differentiation factor 15 in older adults. J Cachexia Sarcopenia Muscle 2022; 13:1003-1012. [PMID: 35132822 PMCID: PMC8977966 DOI: 10.1002/jcsm.12924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 12/14/2021] [Accepted: 01/10/2022] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is a biomarker for chronic disease burden that might explain the health effects of sedentary behaviours (SBs) and physical activity (PA). We examined associations of device-measured sleep, SB and PA, and time reallocations among them, with GDF-15 in older adults. METHODS We used data from 2245 older adults participating in the Seniors-ENRICA-2 study. Wrist-worn accelerometers were employed to ascertain total time in sleep, SB, light PA (LPA) and moderate-to vigorous PA (MVPA). Associations between these activities and serum GDF-15 levels were analysed using linear regression, including isotemporal substitution models for time reallocations among activities, and adjusted for potential confounders. Analyses were conducted separately in two groups (less active and more active individuals) according to the median total PA time. RESULTS In the less active participants, 30 min/day more of MVPA were related to lower levels of GDF-15 when replacing sleep (fully adjusted mean percentage differences [95% confidence interval] in GDF-15 of -9.2% [-13.2, -5.0]), SB (-9.8% [-13.6, -5.8]) and LPA (-5.8% [-11.1, -0.3]), whereas 30 min/day more of LPA were related to lower GDF-15 when replacing both sleep (-3.6% [-6.1, -1.0]) and SB (-4.2% [-6.7, -1.7]). In the more active participants, 30 min/day more of MVPA were also associated with lower GDF-15 when replacing sleep (-2.9% [-5.3, -0.3]), SB (-2.4% [-4.6, -0.2]) and LPA (-3.5% [-6.6, -0.3]), but no associations were found for more time in LPA. Spending more time in SB was associated with higher GDF-15 levels only among those less active (1.9% [0.9, 2.9] per 30 min/day increment). Sleep time did not appear to be associated with GDF-15. CONCLUSIONS The MVPA was inversely associated with GDF-15, with stronger associations at lower PA volumes. Also, more LPA and less SB time were linked to lower GDF-15 in the less active individuals. This suggests that simply moving more and sitting less may reduce chronic disease burden in older adults.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Antonio Buño-Soto
- Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | | | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM + CSIC, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Environmental Health and Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM + CSIC, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.,Cardiovascular and Nutritional Epidemiology Group, IdiPAZ (La Paz University Hospital-Universidad Autónoma de Madrid), Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute. CEI UAM + CSIC, Madrid, Spain
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26
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Yang P, Zhu Z, Shi M, Yin J, Zang Y, Zhong C, Wang A, Peng H, Xu T, Guo D, Xu T, Chen J, Zhang Y, He J. Association of serum growth differentiation factor-15 levels with the risks of death and vascular events in patients with ischemic stroke: The role of diabetes. Nutr Metab Cardiovasc Dis 2022; 32:616-623. [PMID: 35115209 DOI: 10.1016/j.numecd.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/15/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND AND AIMS Researchers have not determined whether the association between growth differentiation factor-15 (GDF-15) levels and stroke outcomes is modified by the diabetes status. We aimed to evaluate the prognostic value of GDF-15 among patients with ischemic stroke stratified by diabetes. METHODS AND RESULTS A total of 3001 patients with ischemic stroke were selected from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) and included in this study. The primary outcome was a composite outcome of death and vascular events at 3 months after acute ischemic stroke. An elevated GDF-15 level was significantly associated with the primary outcome in patients with diabetes but not in those without diabetes (pinteraction = 0.038). The multivariate-adjusted hazard ratio (95% confidence intervals) for the primary outcome was 3.33 (1.07-10.35) when 2 extreme tertiles were compared, and a linear association between GDF-15 levels and the primary outcome was observed in patients with diabetes (p for linearity = 0.046). The addition of serum GDF-15 to conventional risk factors improved the risk prediction for the primary outcome in patients with diabetes (net reclassification improvement: 31.98%, p = 0.043; integrated discrimination index: 0.85%, p = 0.034) but not in those without diabetes. CONCLUSIONS A modifying effect of the diabetes status on the association between serum GDF-15 levels and ischemic stroke prognosis was observed. Elevated serum GDF-15 levels were associated with the primary outcome within 3 months after ischemic stroke in patients with diabetes, suggesting that GDF-15 may be an important prognostic factor for ischemic stroke in patients with diabetes.
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Affiliation(s)
- Pinni Yang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Zhengbao Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Mengyao Shi
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jieyun Yin
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Yuhan Zang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Hao Peng
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Tian Xu
- Department of Neurology, Affiliated Hospital of Nantong University, Nantong, China
| | - Daoxia Guo
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China
| | - Jing Chen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
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27
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Greenspace, Inflammation, Cardiovascular Health, and Cancer: A Review and Conceptual Framework for Greenspace in Cardio-Oncology Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042426. [PMID: 35206610 PMCID: PMC8872601 DOI: 10.3390/ijerph19042426] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 02/04/2023]
Abstract
Cardiovascular disease (CVD) is a leading cause of global morbidity and mortality. Cancer survivors have significantly elevated risk of poor cardiovascular (CV) health outcomes due to close co-morbid linkages and shared risk factors between CVD and cancer, as well as adverse effects of cancer treatment-related cardiotoxicity. CVD and cancer-related outcomes are exacerbated by increased risk of inflammation. Results from different pharmacological interventions aimed at reducing inflammation and risk of major adverse cardiovascular events (MACEs) have been largely mixed to date. Greenspaces have been shown to reduce inflammation and have been associated with CV health benefits, including reduced CVD behavioral risk factors and overall improvement in CV outcomes. Greenspace may, thus, serve to alleviate the CVD burden among cancer survivors. To understand pathways through which greenspace can prevent or reduce adverse CV outcomes among cancer survivors, we review the state of knowledge on associations among inflammation, CVD, cancer, and existing pharmacological interventions. We then discuss greenspace benefits for CV health from ecological to multilevel studies and a few existing experimental studies. Furthermore, we review the relationship between greenspace and inflammation, and we highlight forest bathing in Asian-based studies while presenting existing research gaps in the US literature. Then, we use the socioecological model of health to present an expanded conceptual framework to help fill this US literature gap. Lastly, we present a way forward, including implications for translational science and a brief discussion on necessities for virtual nature and/or exposure to nature images due to the increasing human-nature disconnect; we also offer guidance for greenspace research in cardio-oncology to improve CV health outcomes among cancer survivors.
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28
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Srour B, Hynes LC, Johnson T, Kühn T, Katzke VA, Kaaks R. Serum markers of biological ageing provide long-term prediction of life expectancy-a longitudinal analysis in middle-aged and older German adults. Age Ageing 2022; 51:6527378. [PMID: 35150586 DOI: 10.1093/ageing/afab271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND lifestyle behaviours and chronic co-morbidities are leading risk factors for premature mortality and collectively predict wide variability in individual life expectancy (LE). We investigated whether a pre-selected panel of five serum markers of biological ageing could improve predicting the long-term mortality risk and LE in middle-aged and older women and men. METHODS we conducted a case-cohort study (n = 5,789 among which there were 2,571 deaths) within the European Prospective Investigation into Cancer-Heidelberg cohort, a population cohort of middle-aged and older individuals, followed over a median duration of 18 years. Gompertz models were used to compute multi-adjusted associations of growth differentiation factor-15, N-terminal pro-brain natriuretic peptide, glycated haemoglobin A1c, C-reactive protein and cystatin-C with mortality risk. Areas under estimated Gompertz survival curves were used to estimate the LE of individuals using a model with lifestyle-related risk factors only (smoking history, body mass index, waist circumference, alcohol, physical inactivity, diabetes and hypertension), or with lifestyle factors plus the ageing-related markers. RESULTS a model including only lifestyle-related factors predicted a LE difference of 16.8 [95% confidence interval: 15.9; 19.1] years in men and 9.87 [9.20; 13.1] years in women aged ≥60 years by comparing individuals in the highest versus the lowest quintiles of estimated mortality risk. Including the ageing-related biomarkers in the model increased these differences up to 22.7 [22.3; 26.9] years in men and 14.00 [12.9; 18.2] years in women. CONCLUSIONS serum markers of ageing are potentially strong predictors for long-term mortality risk in a general population sample of older and middle-aged individuals and may help to identify individuals at higher risk of premature death, who could benefit from interventions to prevent further ageing-related health declines.
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Affiliation(s)
- Bernard Srour
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg 69120, Germany
| | - Lucas Cory Hynes
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg 69120, Germany
| | - Theron Johnson
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg 69120, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg 69120, Germany
- Institute for Global Food Security, Queen’s University Belfast, Belfast, Northern Ireland
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg 69120, Germany
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, Heidelberg 69120, Germany
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29
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Mo Q, Zhuo L, Liao Z, Li R, Chen Y, Geng J. Serum GDF-15 Predicts In-Hospital Mortality and Arrhythmic Risks in Patients With Acute Myocardial Infarction. Clin Appl Thromb Hemost 2022; 28:10760296211063875. [PMID: 35001647 PMCID: PMC8753242 DOI: 10.1177/10760296211063875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This study aims to evaluate the association of serum growth differentiation factor 15 (GDF-15) with in-hospital mortality and arrhythmic risks in patients with acute myocardial infarction (AMI). A total of 296 consecutive patients with AMI were enrolled in our hospital from Jan. 2018 to Dec. 2020. Serum GDF-15 levels were measured at baseline. The primary endpoint was in-hospital all-cause mortality, and the secondary endpoint was major adverse cardiac events (MACEs) during hospitalization, defined as a composite of cardiovascular death, heart failure, sustained ventricular arrhythmias (ventricular tachycardia or ventricular fibrillation), and bleeding. During hospitalization, patients with a higher GDF-15 level had significantly higher incidences of in-hospital mortality (7.4% vs 1.4%; P = .02) and MACEs (9.5% vs 20.9%, P < .01) than those with a lower GDF-15 level. Multivariate logistic regression analysis showed that a higher GDF-15 level was significantly associated with increased risks of in-hospital mortality (OR = 1.92, 95% CI: 1.44-2.50; P < .01) and MACEs (OR = 2.19, 95% CI: 1.56-2.77; P < .01). In conclusion, GDF-15 was associated with the risks of in-hospital mortality and MACEs, indicating that it should be a prognostic biomarker for patients with AMI.
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Affiliation(s)
- Qiuping Mo
- Liuzhou People's Hospital, Liuzhou, Guangxi, China
| | - Liuan Zhuo
- Liuzhou People's Hospital, Liuzhou, Guangxi, China
| | - Zhihong Liao
- Liuzhou People's Hospital, Liuzhou, Guangxi, China
| | - Rongshan Li
- Liuzhou People's Hospital, Liuzhou, Guangxi, China
| | - Yu Chen
- Liuzhou People's Hospital, Liuzhou, Guangxi, China
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30
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Hsiao YT, Shimizu I, Yoshida Y, Minamino T. Role of circulating molecules in age-related cardiovascular and metabolic disorders. Inflamm Regen 2022; 42:2. [PMID: 35012677 PMCID: PMC8744343 DOI: 10.1186/s41232-021-00187-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/30/2021] [Indexed: 12/12/2022] Open
Abstract
Studies analyzing heterochronic parabiosis mice models showed that molecules in the blood of young mice rejuvenate aged mice. Therefore, blood-based therapies have become one of the therapeutic approaches to be considered for age-related diseases. Blood includes numerous biologically active molecules such as proteins, metabolites, hormones, miRNAs, etc. and accumulating evidence indicates some of these change their concentration with chronological aging or age-related disorders. The level of some circulating molecules showed a negative or positive correlation with all-cause mortality, cardiovascular events, or metabolic disorders. Through analyses of clinical/translation/basic research, some molecules were focused on as therapeutic targets. One approach is the supplementation of circulating anti-aging molecules. Favorable results in preclinical studies let some molecules to be tested in humans. These showed beneficial or neutral results, and some were inconsistent. Studies with rodents and humans indicate circulating molecules can be recognized as biomarkers or therapeutic targets mediating their pro-aging or anti-aging effects. Characterization of these molecules with aging, testing their biological effects, and finding mimetics of young systemic milieu continue to be an interesting and important research topic to be explored.
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Affiliation(s)
- Yung Ting Hsiao
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
- Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Ippei Shimizu
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
| | - Yohko Yoshida
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan
- Department of Advanced Senotherapeutics, Juntendo University Graduate School of Medicine, Tokyo, 113-8431, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8431, Japan.
- Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, 100-0004, Japan.
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31
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Yan Z, Wang G, Shi X. Advances in the Progression and Prognosis Biomarkers of Chronic Kidney Disease. Front Pharmacol 2022; 12:785375. [PMID: 34992536 PMCID: PMC8724575 DOI: 10.3389/fphar.2021.785375] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/30/2021] [Indexed: 12/29/2022] Open
Abstract
Chronic kidney disease (CKD) is one of the increasingly serious public health concerns worldwide; the global burden of CKD is increasingly due to high morbidity and mortality. At present, there are three key problems in the clinical treatment and management of CKD. First, the current diagnostic indicators, such as proteinuria and serum creatinine, are greatly interfered by the physiological conditions of patients, and the changes in the indicator level are not synchronized with renal damage. Second, the established diagnosis of suspected CKD still depends on biopsy, which is not suitable for contraindication patients, is also traumatic, and is not sensitive to early progression. Finally, the prognosis of CKD is affected by many factors; hence, it is ineviatble to develop effective biomarkers to predict CKD prognosis and improve the prognosis through early intervention. Accurate progression monitoring and prognosis improvement of CKD are extremely significant for improving the clinical treatment and management of CKD and reducing the social burden. Therefore, biomarkers reported in recent years, which could play important roles in accurate progression monitoring and prognosis improvement of CKD, were concluded and highlighted in this review article that aims to provide a reference for both the construction of CKD precision therapy system and the pharmaceutical research and development.
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Affiliation(s)
- Zhonghong Yan
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Guanran Wang
- Heilongjiang University of Chinese Medicine, Harbin, China.,Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xingyang Shi
- Heilongjiang University of Chinese Medicine, Harbin, China
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32
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Tanaka T, Ferrucci L. Editorial: A Golden Age of Aging Biomarker Discovery. J Nutr Health Aging 2022; 26:543-544. [PMID: 35718860 DOI: 10.1007/s12603-022-1808-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- T Tanaka
- Toshiko Tanaka National Institute on Aging, Baltimore, MD, USA,
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33
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Xiao QA, He Q, Zeng J, Xia X. GDF-15, a future therapeutic target of glucolipid metabolic disorders and cardiovascular disease. Biomed Pharmacother 2021; 146:112582. [PMID: 34959119 DOI: 10.1016/j.biopha.2021.112582] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Growth and differentiation factor 15 (GDF-15) was discovered as a member of the transforming growth factor β (TGF-β) superfamily and the serum level of GDF-15 was significantly correlated with glucolipid metabolic disorders (GLMD) and cardiovascular diseases. In 2017, a novel identified receptor of GDF-15-glial-derived neurotrophic factor receptor alpha-like (GFRAL) was found to regulate energy homeostasis (such as obesity, diabetes and non-alcoholic fatty liver disease (NAFLD)). The function of GDF-15/GFRAL in suppressing appetite, enhancing glucose/lipid metabolism and vascular remodeling has been gradually revealed. These effects make it a potential therapeutic target for GLMD and vascular diseases. In this narrative review, we included and reviewed 121 articles by screening 524 articles from literature database. We primarily focused on the function of GDF-15 and its role in GLMD/cardiovascular diseases and discuss its potential clinical application.
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Affiliation(s)
- Qing-Ao Xiao
- Department of Endocrinology, The People's Hospital of China Three Gorges University/the First People's Hospital of Yichang, Yichang 443000, China; Third-Grade Pharmacological Laboratory on Traditional Chinese Medicine, State Administration of Traditional Chinese Medicine, China Three Gorges University, Yichang 443002, China
| | - Qian He
- Department of Geriatrics, The People's Hospital of China Three Gorges University/the First People's Hospital of Yichang, Yichang 443000, China
| | - Jun Zeng
- Department of Endocrinology, The People's Hospital of China Three Gorges University/the First People's Hospital of Yichang, Yichang 443000, China.
| | - Xuan Xia
- Third-Grade Pharmacological Laboratory on Traditional Chinese Medicine, State Administration of Traditional Chinese Medicine, China Three Gorges University, Yichang 443002, China; Department of Physiology and Pathophysiology, Medical College, China Three Gorges University, Yichang 443002, China.
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34
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Srour B, Kaaks R, Johnson T, Hynes LC, Kühn T, Katzke VA. Ageing-related markers and risks of cancer and cardiovascular disease: a prospective study in the EPIC-Heidelberg cohort. Eur J Epidemiol 2021; 37:49-65. [PMID: 34935094 PMCID: PMC8791871 DOI: 10.1007/s10654-021-00828-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 12/02/2021] [Indexed: 11/25/2022]
Abstract
Biological age is an important risk factor for chronic diseases. We examined the associations between five markers of unhealthy ageing; Growth Differentiation Factor-15 (GDF-15), N-terminal pro-brain natriuretic peptide (NT-proBNP), glycated hemoglobin A1c (HbA1C), C-Reactive Protein (CRP) and cystatin-C; with risks of cancer and cardiovascular disease (CVD). We used a case-cohort design embedded in the EPIC-Heidelberg cohort, including a subcohort of 3792 participants along with 4867 incident cases of cancer and CVD. Hazard ratios (HRs) were computed and the strongest associations were used to build weighted multi-marker combinations, and their associations with cancer and CVD risks were tested. After adjusting for common confounders, we observed direct associations of GDF-15 with lung cancer risk, NT-proBNP with breast, prostate and colorectal cancers, HbA1C with lung, colorectal, and breast cancer risks, and CRP with lung and colorectal cancer risks. An inverse association was observed for GDF-15 and prostate cancer risk. We also found direct associations of all 5 markers with myocardial infarction (MI) risk, and of GDF-15, NT-proBNP, CRP and cystatin-C with stroke risk. A combination of the independently-associated markers showed a moderately strong association with the risks of cancer and CVD (HRQ4-Q1 ranged from 1.78[1.36, 2.34] for breast cancer, when combining NT-proBNP and HbA1C, to 2.87[2.15, 3.83] for MI when combining NT-proBNP, HbA1C, CRP and cystatin-C). This analysis suggests that combinations of biomarkers related to unhealthy ageing show strong associations with cancer risk, and corroborates published evidence on CVD risk. If confirmed in other studies, using these biomarkers could be useful for the identification of individuals at higher risk of age-related diseases.
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Affiliation(s)
- Bernard Srour
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, 69120, Heidelberg, Germany.
| | - Rudolf Kaaks
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, 69120, Heidelberg, Germany
| | - Theron Johnson
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, 69120, Heidelberg, Germany
| | - Lucas Cory Hynes
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, 69120, Heidelberg, Germany
| | - Tilman Kühn
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, 69120, Heidelberg, Germany.,Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Verena A Katzke
- Division of Cancer Epidemiology, German Cancer Research Center, DKFZ, 69120, Heidelberg, Germany.
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35
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Negishi K, Hoshide S, Shimpo M, Kanegae H, Kario K. Growth Differentiation Factor-15 Predicts Death and Stroke Event in Outpatients With Cardiovascular Risk Factors: The J-HOP Study. J Am Heart Assoc 2021; 10:e022601. [PMID: 34889104 PMCID: PMC9075247 DOI: 10.1161/jaha.121.022601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Growth differentiation factor-15 (GDF-15) has emerged as a novel biomarker to predict all-cause death in community-dwelling individuals and patients with cardiovascular disease. We evaluated the prognostic value of GDF-15 in outpatients with cardiovascular risk factors. Methods and Results GDF-15 levels were measured in 3562 outpatients with cardiovascular risk factors in the J-HOP (Japan Morning Surge-Home Blood Pressure) study, a nationwide prospective study. Participants were stratified according to tertiles of GDF-15 and followed up for all-cause death and cardiovascular disease. During a mean follow-up period of 6.6 years, there were 155 all-cause deaths, 81 stroke events including cerebral infarction and intracranial hemorrhage, and 141 cardiac events including cardiac artery disease and heart failure. Patients with higher GDF-15 levels were associated with risks of all-cause death and stroke events (except for cardiac events) after adjustment for traditional risk factors and other prognostic biomarkers (NT-proBNP [N-terminal pro-B-type natriuretic peptide], high-sensitivity troponin T; all-cause death, hazard ratio, 2.38; 95% CI, 1.26-4.48; P=0.007; stroke events, hazard ratio, 2.93; 95% CI, 1.31-6.56, P=0.009; compared with the lowest tertile). Furthermore, incorporating GDF-15 to the predictive models for all-cause death improved discrimination and reclassification significantly. For stroke events, GDF-15 showed similar diagnostic accuracy to NT-proBNP and high-sensitivity troponin T. Conclusions In Japanese outpatients with cardiovascular risk factors, GDF-15 improves risk stratification for all-cause death when compared with NT-proBNP and high-sensitivity troponin T. GDF-15 was associated with increased risks of stroke events beyond conventional risk factors and other prognostic markers; however, the predictive ability for stroke events was equivalent to NT-proBNP and high-sensitivity troponin T. Registration URL: http://www.umin.ac.jp/ctr.; Unique identifier: UMIN000000894.
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Affiliation(s)
- Keita Negishi
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi Japan
| | - Masahisa Shimpo
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi Japan
| | - Hiroshi Kanegae
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi Japan.,Genki Plaza Medical Center for Health Care Tokyo Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine Department of Medicine Jichi Medical University Tochigi Japan
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36
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Bonaterra GA, Struck N, Zuegel S, Schwarz A, Mey L, Schwarzbach H, Strelau J, Kinscherf R. Characterization of atherosclerotic plaques in blood vessels with low oxygenated blood and blood pressure (Pulmonary trunk): role of growth differentiation factor-15 (GDF-15). BMC Cardiovasc Disord 2021; 21:601. [PMID: 34920697 PMCID: PMC8684150 DOI: 10.1186/s12872-021-02420-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 12/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Growth differentiation factor (GDF)-15 is linked to inflammation, cancer, and atherosclerosis. GDF-15 is expressed in most tissues but is extremely induced under pathological conditions. Elevated serum levels are suggested as a risk factor and a marker for cardiovascular diseases. However, the cellular sources and the effects of GDF-15 on the cardiovascular system have not been completely elucidated including progression, and morphology of atherosclerotic plaques. Thus, this work aimed to characterize the influence of GDF-15 deficiency on the morphology of atherosclerotic plaques in blood vessels with low-oxygen blood and low blood pressure as the pulmonary trunk (PT), in hypercholesterolemic ApoE-/- mice. METHODS GDF-15-/- ApoE-/- mice were generated by crossbreeding of ApoE-/-- and GDF-15-/- mice. After feeding a cholesterol-enriched diet (CED) for 20 weeks, samples of the brachiocephalic trunk (BT) and PT were dissected and lumen stenosis (LS) was measured. Furthermore, changes in the cellularity of the PT, amounts of apoptosis-, autophagy-, inflammation- and proliferation-relevant proteins were immunohisto-morphometrically analyzed. Additionally, we examined an atherosclerotic plaque in a human post mortem sample of the pulmonary artery. RESULTS After CED the body weight of GDF-15-/-ApoE-/- was 22.9% higher than ApoE-/-. Double knockout mice showed also an 35.3% increase of plasma triglyceride levels, whereas plasma cholesterol was similar in both genotypes. LS in the BT and PT of GDF-15-/-ApoE-/- mice was significantly reduced by 19.0% and by 6.7% compared to ApoE-/-. Comparing LS in PT and BT of the same genotype revealed a significant 38.8% (ApoE-/-) or 26.4% (GDF-15-/-ApoE-/-) lower LS in the PT. Immunohistomorphometry of atherosclerotic lesions in PT of GDF-15-/-ApoE-/- revealed significantly increased levels (39.8% and 7.3%) of CD68 + macrophages (MΦ) and α-actin + smooth muscle cells than in ApoE-/-. The density of TUNEL + , apoptotic cells was significantly (32.9%) higher in plaques of PT of GDF-15-/-ApoE-/- than in ApoE-/-. Analysis of atherosclerotic lesion of a human pulmonary artery showed sm-α-actin, CD68+, TUNEL+, Ki67+, and APG5L/ATG+ cells as observed in PT. COX-2+ and IL-6+ immunoreactivities were predominantly located in endothelial cells and subendothelial space. In BT and PT of GDF15-/-ApoE-/- mice the necrotic area was 10% and 6.5% lower than in ApoE-/-. In BT and PT of GDF15-/-ApoE-/- we found 40% and 57% less unstable plaques than ApoE-/- mice. CONCLUSIONS Atherosclerotic lesions occur in both, BT and PT, however, the size is smaller in PT, possibly due to the effect of the low-oxygen blood and/or lower blood pressure. GDF-15 is involved in atherosclerotic processes in BT and PT, although different mechanisms (e.g. apoptosis) in these two vessels seem to exist.
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Affiliation(s)
- G A Bonaterra
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany.
| | - N Struck
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - S Zuegel
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - A Schwarz
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - L Mey
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - H Schwarzbach
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
| | - J Strelau
- Department of Functional Neuroanatomy, University of Heidelberg, 69120, Heidelberg, Germany
| | - R Kinscherf
- Institute for Anatomy and Cell Biology, Department of Medical Cell Biology, University of Marburg, 35032, Marburg, Germany
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37
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Laucyte-Cibulskiene A, Ward LJ, Ebert T, Tosti G, Tucci C, Hernandez L, Kautzky-Willer A, Herrero MT, Norris CM, Pilote L, Söderberg M, Brismar TB, Ripsweden J, Stenvinkel P, Raparelli V, Kublickiene K. Role of GDF-15, YKL-40 and MMP 9 in patients with end-stage kidney disease: focus on sex-specific associations with vascular outcomes and all-cause mortality. Biol Sex Differ 2021; 12:50. [PMID: 34526107 PMCID: PMC8444580 DOI: 10.1186/s13293-021-00393-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/29/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sex differences are underappreciated in the current understanding of cardiovascular disease (CVD) in association with chronic kidney disease (CKD). A hallmark of CKD is vascular aging that is characterised, amongst others, by; systemic inflammation, microbiota disbalance, oxidative stress, and vascular calcification-features linked to atherosclerosis/arteriosclerosis development. Thus, it is the necessary to introduce novel biomarkers related to athero-/arteriosclerotic damage for better assessment of vascular ageing in patients CKD. However, little is known about the relationship between uraemia and novel CVD biomarkers, such as growth differentiation factor-15 (GDF-15), cartilage glycoprotein-39 (YKL-40) and matrix metalloproteinase-9 (MMP-9). Therefore, we hypothesise that there are sex-specific relationships between GDF-15, YKL-40, MMP-9 levels in end-stage kidney disease (ESKD) patients in relation to gut microbiota, vascular calcification, inflammation, comorbidities, and all-cause mortality. METHODS ESKD patients, males (n = 151) and females (n = 79), not receiving renal replacement therapy were selected from two ongoing prospective ESKD cohorts. GDF-15, YKL-40 and MMP9 were analysed using enzyme-linked immunosorbent assay kits. Biomarker levels were analysed in the context of gut microbiota-derived trimethylamine N-oxide (TMAO), vascular calcification, inflammatory response, oxidative stress, comorbidities, and all-cause mortality. RESULTS Increased GDF-15 correlated with higher TMAO in females only, and with higher coronary artery calcification and IL-6. In females, diabetes was associated with elevated GDF-15 and MMP-9, whilst males with diabetes only had elevated GDF-15. No associations were found between biomarkers and CVD comorbidity. Deceased males and females had higher GDF-15 concentrations (p = 0.01 and p < 0.001, respectively), meanwhile only YKL-40 was increased in deceased males (p = 0.02). CONCLUSIONS In conclusion, in males GDF-15 and YKL-40 were related to vascular calcification, inflammation, and oxidative stress, whilst in females GDF-15 was related to TMAO. Increased levels of YKL-40 and GDF-15 in males, and only GDF-15 in females, were associated with all-cause mortality. Our findings suggest that sex-specific associations of novel CVD biomarkers have a potential to affect development of cardiovascular complications in patients with ESKD.
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Affiliation(s)
- Agne Laucyte-Cibulskiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Nephrology, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Liam J Ward
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Ebert
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Giulia Tosti
- Institute of Internal Medicine, Catholic University of Rome, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Claudia Tucci
- Department of Biomedical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Leah Hernandez
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Maria-Trinidad Herrero
- Clinical and Experimental Neuroscience, Institutes for Aging Research and Bio-Health Research of Murcia, School of Medicine, University of Murcia, Murcia, Spain
| | - Colleen M Norris
- University of Alberta, Faculty of Nursing, Edmonton, AB, Canada
- Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, AB, Canada
| | - Louise Pilote
- Division of Clinical Epidemiology, Research Institute of McGill University Health Centre, McGill University, Montreal, QC, Canada
| | - Magnus Söderberg
- Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Göteborg, Sweden
| | - Torkel B Brismar
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Jonaz Ripsweden
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Peter Stenvinkel
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
| | - Valeria Raparelli
- University of Alberta, Faculty of Nursing, Edmonton, AB, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Karolina Kublickiene
- Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
- Division of Renal Medicine, Department for Clinical Science, Intervention & Technology, Karolinska University Hospital-Flemingsberg Campus, 14186, Stockholm, Sweden.
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38
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Jovani M, Liu EE, Paniagua SM, Lau ES, Li SX, Takvorian KS, Kreger BE, Splansky GL, de Boer RA, Joshi AD, Hwang SJ, Yao C, Huan T, Courchesne P, Larson MG, Levy D, Chan AT, Ho JE. Cardiovascular disease related circulating biomarkers and cancer incidence and mortality: is there an association? Cardiovasc Res 2021; 118:2317-2328. [PMID: 34469519 DOI: 10.1093/cvr/cvab282] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/25/2020] [Accepted: 08/30/2021] [Indexed: 12/14/2022] Open
Abstract
AIMS Recent studies suggest an association between cardiovascular disease (CVD) and cancer incidence/mortality, but the pathophysiological mechanisms underlying these associations are unclear. We aimed to examine biomarkers previously associated with CVD and study their association with incident cancer and cancer-related death in a prospective cohort study. METHODS AND RESULTS We used a proteomic platform to measure 71 cardiovascular biomarkers among 5,032 participants in the Framingham Heart Study who were free of cancer at baseline. We used multivariable-adjusted Cox models to examine the association of circulating protein biomarkers with risk of cancer incidence and mortality. To account for multiple testing, we set a 2-sided false discovery rate (FDR Q-value) <0.05.Growth differentiation factor-15 (GDF15; also known as macrophage inhibitory cytokine-1 [MIC1])) was associated with increased risk of incident cancer (hazards ratio [HR] per 1 standard deviation increment 1.31, 95% CI 1.17-1.47), incident gastrointestinal cancer (HR 1.85, 95% CI 1.37-2.50), incident colorectal cancer (HR 1.94, 95% CI 1.29-2.91) and cancer-related death (HR 2.15, 95% CI 1.72-2.70). Stromal cell-derived factor-1 (SFD1) showed an inverse association with cancer-related death (HR 0.75, 95% CI 0.65-0.86). Fibroblast growth factor-23 (FGF23) showed an association with colorectal cancer (HR 1.55, 95% CI 1.20-2.00), and granulin (GRN) was associated with hematologic cancer (HR 1.61, 95% CI 1.30-1.99). Other circulating biomarkers of inflammation, immune activation, metabolism, and fibrosis showed suggestive associations with future cancer diagnosis. CONCLUSION We observed several significant associations between circulating CVD biomarkers and cancer, supporting the idea that shared biological pathways underlie both diseases. Further investigations of specific mechanisms that lead to both CVD and cancer are warranted. TRANSLATIONAL PERSPECTIVE In our prospective cohort study, baseline levels of biomarkers previously associated with CVD were found to be associated with future development of cancer. In particular, GDF15 was associated with increased risk of cancer incidence and mortality, including gastrointestinal and colorectal cancers; SDF1 was inversely associated with cancer-related death, and FGF23 and GRN were associated with increased risk of colorectal and hematologic cancers, respectively. Other biomarkers of inflammation, immune activation, metabolism, and fibrosis showed suggestive associations. These results suggest potential shared biological pathways that underlie both development of cancer and CVD.
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Affiliation(s)
- Manol Jovani
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA.,Division of Gastroenterology; University of Kentucky Albert B. Chandler Hospital
| | - Elizabeth E Liu
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA
| | | | - Emily S Lau
- Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA.,Cardiology Division, Massachusetts General Hospital, Boston, MA.,Department of Medicine, Massachusetts General Hospital, Boston, MA
| | - Shawn X Li
- Department of Medicine, Massachusetts General Hospital, Boston, MA
| | | | - Bernard E Kreger
- General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA.,The Framingham Heart Study, Framingham, MA
| | | | - Rudolf A de Boer
- Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands
| | - Amit D Joshi
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Shih-Jen Hwang
- The Framingham Heart Study, Framingham, MA.,Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD
| | - Chen Yao
- The Framingham Heart Study, Framingham, MA.,Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD
| | - Tianxiao Huan
- The Framingham Heart Study, Framingham, MA.,Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD
| | - Paul Courchesne
- The Framingham Heart Study, Framingham, MA.,Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD
| | - Martin G Larson
- The Framingham Heart Study, Framingham, MA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Daniel Levy
- The Framingham Heart Study, Framingham, MA.,Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD
| | - Andrew T Chan
- Division of Gastroenterology, Massachusetts General Hospital, Boston, MA.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
| | - Jennifer E Ho
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA.,Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA.,Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA.,Cardiology Division, Massachusetts General Hospital, Boston, MA.,Department of Medicine, Massachusetts General Hospital, Boston, MA.,Harvard Medical School, Boston, MA
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GDF15 and Cardiac Cells: Current Concepts and New Insights. Int J Mol Sci 2021; 22:ijms22168889. [PMID: 34445593 PMCID: PMC8396208 DOI: 10.3390/ijms22168889] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023] Open
Abstract
Growth and differentiation factor 15 (GDF15) belongs to the transforming growth factor-β (TGF-β) superfamily of proteins. Glial-derived neurotrophic factor (GDNF) family receptor α-like (GFRAL) is an endogenous receptor for GDF15 detected selectively in the brain. GDF15 is not normally expressed in the tissue but is prominently induced by “injury”. Serum levels of GDF15 are also increased by aging and in response to cellular stress and mitochondrial dysfunction. It acts as an inflammatory marker and plays a role in the pathogenesis of cardiovascular diseases, metabolic disorders, and neurodegenerative processes. Identified as a new heart-derived endocrine hormone that regulates body growth, GDF15 has a local cardioprotective role, presumably due to its autocrine/paracrine properties: antioxidative, anti-inflammatory, antiapoptotic. GDF15 expression is highly induced in cardiomyocytes after ischemia/reperfusion and in the heart within hours after myocardial infarction (MI). Recent studies show associations between GDF15, inflammation, and cardiac fibrosis during heart failure and MI. However, the reason for this increase in GDF15 production has not been clearly identified. Experimental and clinical studies support the potential use of GDF15 as a novel therapeutic target (1) by modulating metabolic activity and (2) promoting an adaptive angiogenesis and cardiac regenerative process during cardiovascular diseases. In this review, we comment on new aspects of the biology of GDF15 as a cardiac hormone and show that GDF15 may be a predictive biomarker of adverse cardiac events.
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Sanders JL, Putman RK, Dupuis J, Xu H, Murabito JM, Araki T, Nishino M, Benjamin EJ, Levy DL, Ramachandran VS, Washko GR, Curtis JL, Freeman CM, Bowler RP, Hatabu H, O'Connor GT, Hunninghake GM. The Association of Aging Biomarkers, Interstitial Lung Abnormalities, and Mortality. Am J Respir Crit Care Med 2021; 203:1149-1157. [PMID: 33080140 DOI: 10.1164/rccm.202007-2993oc] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Rationale: The association between aging and idiopathic pulmonary fibrosis has been established. The associations between aging-related biomarkers and interstitial lung abnormalities (ILA) have not been comprehensively evaluated.Objectives: To evaluate the associations among aging biomarkers, ILA, and all-cause mortality.Methods: In the FHS (Framingham Heart Study), we evaluated associations among plasma biomarkers (IL-6, CRP [C-reactive protein], TNFR [tumor necrosis factor α receptor II], GDF15 [growth differentiation factor 15], cystatin-C, HGBA1C [Hb A1C], insulin, IGF1 [insulin-like growth factor 1], and IGFBP1 [IGF binding protein 1] and IGFBP3]), ILA, and mortality. Causal inference analysis was used to determine whether biomarkers mediated age. GDF15 results were replicated in the COPDGene (Genetic Epidemiology of Chronic Obstructive Pulmonary Disease) Study.Measurements and Main Results: In the FHS, there were higher odds of ILA per increase in natural log-transformed GDF15 (odds ratio [95% confidence interval], 3.4 [1.8-6.4]; P = 0.0002), TNFR (3.1 [1.6-5.8]; P = 0.004), IL-6 (1.8 [1.4-2.4]; P < 0.0001), and CRP (1.7 [1.3-2.0]; P < 0.0001). In the FHS, after adjustment for multiple comparisons, no biomarker was associated with increased mortality, but the associations of GDF15 (hazard ratio, 2.0 [1.1-3.5]; P = 0.02), TNFR (1.8 [1.0-3.3]; P = 0.05), and IGFBP1 (1.3 [1.1-1.7]; P = 0.01) approached significance. In the COPDGene Study, higher natural log-transformed GDF15 was associated with ILA (odds ratio, 8.1 [3.1-21.4]; P < 0.0001) and mortality (hazard ratio, 1.6 [1.1-2.2]; P = 0.01). Causal inference analysis showed that the association of age with ILA was mediated by IL-6 (P < 0.0001) and TNFR (P = 0.002) and was likely mediated by GDF15 (P = 0.008) in the FHS and was mediated by GDF15 (P = 0.001) in the COPDGene Study.Conclusions: Some aging-related biomarkers are associated with ILA. GDF15, in particular, may explain some of the associations among age, ILA, and mortality.
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Affiliation(s)
| | | | - Josée Dupuis
- Department of Biostatistics, School of Public Health
| | - Hanfei Xu
- Department of Biostatistics, School of Public Health
| | - Joanne M Murabito
- Department of Medicine, and.,Framingham Heart Study, Framingham, Massachusetts
| | - Tetsuro Araki
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Emelia J Benjamin
- Department of Medicine, and.,Framingham Heart Study, Framingham, Massachusetts
| | - Daniel L Levy
- Department of Medicine, and.,Framingham Heart Study, Framingham, Massachusetts
| | | | | | - Jeffrey L Curtis
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan.,Medical Service and
| | - Christine M Freeman
- Division of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, Michigan.,Research Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
| | - Russell P Bowler
- Department of Medicine, National Jewish Health-Health Sciences Center, University of Colorado at Denver, Denver, Colorado
| | - Hiroto Hatabu
- Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts.,Center for Pulmonary Functional Imaging, Brigham and Women's Hospital-Harvard Medical School, Harvard University, Boston, Massachusetts; and
| | - George T O'Connor
- Pulmonary Center, School of Medicine, Boston University, Boston, Massachusetts.,Division of Pulmonary, Allergy, Sleep, and Critical Care Medicine, Boston Medical Center, Boston, Massachusetts
| | - Gary M Hunninghake
- Division of Pulmonary and Critical Care Medicine and.,Center for Pulmonary Functional Imaging, Brigham and Women's Hospital-Harvard Medical School, Harvard University, Boston, Massachusetts; and
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Enarsson M, Feldreich T, Byberg L, Nowak C, Lind L, Ärnlöv J. Association between Cardiorespiratory Fitness and Circulating Proteins in 50-Year-Old Swedish Men and Women: a Cross-Sectional Study. SPORTS MEDICINE-OPEN 2021; 7:52. [PMID: 34312731 PMCID: PMC8313632 DOI: 10.1186/s40798-021-00343-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 07/04/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIMS A strong cardiorespiratory fitness is suggested to have beneficial effects on cardiovascular risk; the exact mechanisms underlying the cardioprotective effects of fitness remain uncertain. Our aim was to investigate associations between cardiorespiratory fitness and multiple plasma proteins, in order to obtain insights about physiological pathways associated with the effects of exercise on cardiovascular health. METHODS In the Prospective investigation of Obesity, Energy and Metabolism (POEM) study (n=444 adults aged 50 years, 50% women), cardiorespiratory fitness was measured by a maximal exercise test on bicycle ergometer with gas exchange (VO2peak) normalized for body lean mass (dual-energy X-ray absorptiometry (DXA)). We measured 82 cardiovascular proteins associated with cardiovascular pathology and inflammation in plasma samples with a proximity extension assay. RESULTS In sex-adjusted linear regression, VO2peak was associated with 18 proteins after Bonferroni correction for multiple testing (p<0.0006). Following additional adjustment for fat mass (DXA), fasting glucose (mmol/L), low-density lipoprotein (LDL, mmol/L), smoking status, waist/hip ratio, blood pressure (mmHg), education level, and lpnr (lab sequence number), higher VO2peak was significantly associated with lower levels of 6 proteins: fatty-acid binding protein-4 (FABP4), interleukin-6 (IL-6), leptin, cystatin-B (CSTB), interleukin-1 receptor antagonist (IL-1RA), and growth differentiation factor 15 (GDF-15), and higher levels of 3 proteins: galanin, kallikrein-6 (KLK6), and heparin-binding EGF-like growth factor (HB-EGF), at nominal p-values (p<0.05). CONCLUSIONS We identified multiple novel associations between cardiorespiratory fitness and plasma proteins involved in several atherosclerotic processes and key cellular mechanisms such as inflammation, energy homeostasis, and protease activity, which shed new light on how exercise asserts its beneficial effects on cardiovascular health. Our findings encourage additional studies in order to understand the underlying causal mechanisms for these associations.
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Affiliation(s)
- Malin Enarsson
- Center for Clinical Research Dalarna, Uppsala University, Region Dalarna, Nissers väg 3, 79182, Falun, Sweden
| | - Tobias Feldreich
- School of Health and Social Studies, Dalarna University, 79188, Falun, Sweden
| | - Liisa Byberg
- Department of Surgical Sciences, Orthopedics, Uppsala University, Dag Hammarskjölds väg 14, B 75185, Uppsala, Sweden
| | - Christoph Nowak
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Alfred Nobels Allé 23, 14183, Huddinge, SE, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Dag Hammarskölds väg 10B, 75237, Uppsala, Sweden
| | - Johan Ärnlöv
- School of Health and Social Studies, Dalarna University, 79188, Falun, Sweden. .,Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Alfred Nobels Allé 23, 14183, Huddinge, SE, Sweden.
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Kim M, Walston JD, Won CW. Associations between elevated growth differentiation factor-15 and sarcopenia among community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2021; 77:770-780. [PMID: 34255062 DOI: 10.1093/gerona/glab201] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is associated with disease progression, mitochondrial dysfunction, and mortality. Elevated GDF-15 level was recently reported to be associated with poorer physical performance in healthy adults. However, the association between serum GDF-15 level and sarcopenia in community-dwelling older adults has not been well characterized. METHODS We conducted cross-sectional (n = 929) and two-year prospective analyses (n = 788) among participants aged 70-84 years enrolled in the Korean Frailty and Aging Cohort Study. Participants with an estimated glomerular filtration rate of <60 mL/min/1.73 m 2 were excluded. Appendicular lean mass was measured using dual-energy X-ray absorptiometry. Sarcopenia status was determined according to the Asian Working Group for Sarcopenia-2019 algorithm. RESULTS At baseline, 16.6% of the participants had sarcopenia. Median GDF-15 concentration was higher in the sarcopenic group than in the non-sarcopenic group (1221 pg/mL vs. 1019 pg/mL, p<0.001). In the multivariate analysis adjusted for cardiometabolic risk and biological factors, the highest GDF-15 tertile (≥1245 pg/mL) had an increased likelihood of sarcopenia (odds ratio, 1.96; 95% confidence interval, 1.16-3.33) than the lowest tertile (<885 pg/mL). During the two-year follow-up period, 67 (10.1%) individuals without sarcopenia at baseline developed sarcopenia. There were no significant associations between baseline serum GDF-15 levels and incident sarcopenia or its components (all p>0.05). CONCLUSIONS Elevated GDF-15 was associated with prevalent sarcopenia but not able to predict incident sarcopenia in the 2-year follow-up. Further studies are needed to explore the pathophysiological roles of GDF-15 in the development of sarcopenia.
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Affiliation(s)
- Miji Kim
- Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea
| | - Jeremy D Walston
- Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland. USA.,Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Chang Won Won
- Department of Family Medicine, College of Medicine, Kyung Hee University, Seoul, Korea
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Meessen JMTA, Cesaroni G, Mureddu GF, Boccanelli A, Wienhues-Thelen UH, Kastner P, Ojeda-Fernandez L, Novelli D, Bazzoni G, Mangiavacchi M, Agabiti N, Masson S, Staszewsky L, Latini R. IGFBP7 and GDF-15, but not P1NP, are associated with cardiac alterations and 10-year outcome in an elderly community-based study. BMC Cardiovasc Disord 2021; 21:328. [PMID: 34217226 PMCID: PMC8254994 DOI: 10.1186/s12872-021-02138-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/24/2021] [Indexed: 12/28/2022] Open
Abstract
Background Little is known about the clinical value of Insulin-like growth factor-binding protein-7 (IGFBP7), a cellular senescence marker, in an elderly general population with multiple co-morbidities and high prevalence of asymptomatic cardiovascular ventricular dysfunction. Inflammation and fibrosis are hallmarks of cardiac aging and remodelling. Therefore, we assessed the clinical performance of IGFBP7 and two other biomarkers reflecting these pathogenic pathways, the growth differentiation factor-15 (GFD-15) and amino-terminal propeptide of type I procollagen (P1NP), for their association with cardiac phenotypes and outcomes in the PREDICTOR study. Methods 2001 community-dwelling subjects aged 65–84 years who had undergone centrally-read echocardiography, were selected through administrative registries. Atrial fibrillation (AF) and 4 echocardiographic patterns were assessed: E/e’ (> 8), enlarged left atrial area, left ventricular hypertrophy (LVH) and reduced midwall circumference shortening (MFS). All-cause and cardiovascular mortality and hospitalization were recorded over a median follow-up of 10.6 years. Results IGFBP7 and GDF-15, but not P1NP, were independently associated with prevalent AF and echocardiographic variables after adjusting for age and sex. After adjustment for clinical risk factors and cardiac patterns or NT-proBNP and hsTnT, both IGFBP7 and GDF-15 independently predicted all-cause mortality, hazard ratios 2.13[1.08–4.22] and 2.03[1.62–2.56] per unit increase of Ln-transformed markers, respectively. Conclusions In a community-based elderly cohort, IGFBP7 and GDF-15 appear associated to cardiac alterations as well as to 10-year risk of all-cause mortality. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02138-8.
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Affiliation(s)
- Jennifer M T A Meessen
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Giulia Cesaroni
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Gian F Mureddu
- Department of Cardiovascular Diseases, S Giovanni-Addolorata Hospital, Rome, Italy
| | | | | | | | - Luisa Ojeda-Fernandez
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Deborah Novelli
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Gianfranco Bazzoni
- Department of Biochemistry and Molecular Pharmacology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | | | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Serge Masson
- Roche Diagnostics International, Rotkreuz, Switzerland
| | - Lidia Staszewsky
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Roberto Latini
- Department of Cardiovascular Medicine, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
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Kumric M, Ticinovic Kurir T, Borovac JA, Bozic J. Role of novel biomarkers in diabetic cardiomyopathy. World J Diabetes 2021; 12:685-705. [PMID: 34168722 PMCID: PMC8192249 DOI: 10.4239/wjd.v12.i6.685] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/22/2021] [Accepted: 03/18/2021] [Indexed: 02/06/2023] Open
Abstract
Diabetic cardiomyopathy (DCM) is commonly defined as cardiomyopathy in patients with diabetes mellitus in the absence of coronary artery disease and hypertension. As DCM is now recognized as a cause of substantial morbidity and mortality among patients with diabetes mellitus and clinical diagnosis is still inappropriate, various expert groups struggled to identify a suitable biomarker that will help in the recognition and management of DCM, with little success so far. Hence, we thought it important to address the role of biomarkers that have shown potential in either human or animal studies and which could eventually result in mitigating the poor outcomes of DCM. Among the array of biomarkers we thoroughly analyzed, long noncoding ribonucleic acids, soluble form of suppression of tumorigenicity 2 and galectin-3 seem to be most beneficial for DCM detection, as their plasma/serum levels accurately correlate with the early stages of DCM. The combination of relatively inexpensive and accurate speckle tracking echocardiography with some of the highlighted biomarkers may be a promising screening method for newly diagnosed diabetes mellitus type 2 patients. The purpose of the screening test would be to direct affected patients to more specific confirmation tests. This perspective is in concordance with current guidelines that accentuate the importance of an interdisciplinary team-based approach.
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Affiliation(s)
- Marko Kumric
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
| | - Tina Ticinovic Kurir
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
- Department of Endocrinology, University Hospital of Split, Split 21000, Croatia
| | - Josip A Borovac
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
- Emergency Medicine, Institute of Emergency Medicine of Split-Dalmatia County, Split 21000, Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
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Song L, Söderholm M, Svensson EH, Borné Y, Engström G. Circulating Growth Differentiation Factor 15 Levels Are Associated With Risk of Both Intracerebral and Subarachnoid Hemorrhage. Front Neurol 2021; 12:664010. [PMID: 34177769 PMCID: PMC8221424 DOI: 10.3389/fneur.2021.664010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 05/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Growth differentiation factor 15 (GDF-15) has been associated with the risk of developing major bleedings, including but not restricted to intracranial hemorrhages, in patients on oral anticoagulants or dual antiplatelet therapy. We hypothesized that there may be an association of GDF-15 with incidence of hemorrhagic strokes in the general population, which has not been investigated before. Methods: Two different case-control studies, one for intracerebral hemorrhage (ICH) and one for subarachnoid hemorrhage (SAH), nested within the population-based Malmö Diet and Cancer cohort, were defined using the incidence density sampling method. GDF-15 was analyzed in frozen blood samples taken at the baseline examination in 1991–1996. The associations between GDF-15 and incident ICH (220 cases, 244 controls) and incident SAH (79 cases, 261 controls), respectively, were explored using conditional logistic regression adjusting for risk factors. Results: GDF-15 levels at baseline were higher in both incident ICH and SAH cases, compared with their respective control subjects. After adjustment for risk factors, significant relationships with high GDF-15 concentrations were observed both for incident ICH (odds ratio (OR) per 1 log2 unit: 2.27, 95% confidence interval (CI): 1.52–3.41; P = 7.1 × 10−5) and incident SAH (OR: 2.16, 95% CI: 1.29–3.59; P = 0.0032). Conclusions: High circulating GDF-15 levels were associated with incident ICH and incident SAH, independently of the main risk factors.
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Affiliation(s)
- Lu Song
- Department of Neurology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Martin Söderholm
- Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Malmö, Sweden
| | | | - Yan Borné
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
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Negishi K, Hoshide S, Shimpo M, Kario K. Growth Differentiation Factor 15 Predicts Cancer Death in Patients With Cardiovascular Risk Factors: The J-HOP Study. Front Cardiovasc Med 2021; 8:660317. [PMID: 34150865 PMCID: PMC8211884 DOI: 10.3389/fcvm.2021.660317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Disease-related anorexia-cachexia is associated with poor prognosis of patients with cardiovascular disease (CVD) or cancer. Growth differentiation factor-15 (GDF-15) has emerged as a central regulator of appetite and body weight. However, the exact role of GDF-15 in lean patients has not been elucidated. Aim: Our aim is to evaluate whether the association of GDF-15 with mortality, including cancer death, differs according to body mass index (BMI) level. Methods and Results: We collected blood samples from 4,061 patients with CV risk factors who were enrolled in the nationwide practice-based J-HOP (Japan Morning Surge-Home Blood Pressure) study. Serum GDF-15 levels were determined by immunoassay analysis. During a mean follow-up period of 6.6 years, we observed 174 (6.7/1000 person-year) all-cause deaths, 68 (2.6/1000 person-year) cancer deaths, and 56 (2.2/1000 person-year) CV deaths. Patients were stratified according to the cut-points of GDF-15 at 1,200 ng/L and BMI at 22.5 and 25.0 kg/m2. The association between the GDF-15/BMI based study groups and each outcome was evaluated by Cox-proportional hazard models with adjustment for established risk factors. The multivariate Cox regression model showed that patients with elevated GDF-15 (≥1,200 ng/L) and low BMI (<22.5 kg/m2) were significantly associated with increased risk of all outcomes [all-cause death, hazard ratio (HR) 3.15, 95% confidence interval (CI) 1.85-5.34, p < 0.001; cancer death, HR 3.52, 95%CI 1.64-7.57, p = 0.001; CV death, HR 2.88, 95%CI 1.20-6.92, p = 0.018, respectively] compared to a reference group with non-elevated GDF-15 and normal BMI (22.5-25.0 kg/m2). In analyses of a subgroup with low BMI (<22.5 kg/m2), patients with elevated GDF-15 had 4.79-fold increased risk of cancer death and 11-fold greater risk of CV death when compared with patients with non-elevated GDF-15 (<1,200 ng/L) after adjustment for established risk factors. Conclusion: In patients with CV risk factors, GDF-15 was associated with all-cause, cancer, and CV death. This relationship was especially remarkable in patients with low BMI. The serum GDF-15 levels in patients with low BMI might be a useful marker to identify the potential for anorexia-cachexia associated with CVD and cancer.
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Affiliation(s)
- Keita Negishi
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan.,Jichi Medical University Center of Excellence, Community Medicine Cardiovascular Research and Development, Tochigi, Japan
| | - Masahisa Shimpo
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Tochigi, Japan
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Nopp S, Königsbrügge O, Kraemmer D, Pabinger I, Ay C. Growth differentiation factor-15 predicts major adverse cardiac events and all-cause mortality in patients with atrial fibrillation. Eur J Intern Med 2021; 88:35-42. [PMID: 33706979 DOI: 10.1016/j.ejim.2021.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/01/2021] [Accepted: 02/14/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Growth-differentiation factor-15 (GDF-15) has recently been described as a potential biomarker for predicting risk of mortality and cardiovascular events in patients with atrial fibrillation (AF) but requires validation in clinical practice. METHODS The study population consisted of 362 patients (mean age: 71 years, 37% women) with non-valvular AF included in a prospective cohort study. Relationship of GDF-15 with all-cause mortality and major adverse cardiac events (MACE) was analyzed using Cox regression. Survival analysis stratified by GDF-15 was based on national death records, while MACE was recorded at personal follow-up. Further, we evaluated the recently developed GDF-15 based prognostic score towards prediction of all-cause mortality (ABC-death score). RESULTS Over a median observation period of 4.3 years, 81 (23.3%) patients died, and over a median personal follow-up of 316 days 47 MACE occurred. GDF-15 was independently associated with all-cause mortality (adjusted HR per double increase 2.33, 95%CI 1.74-3.13) and MACE (adjusted HR per double increase 2.33, 95%CI 1.60-3.39). GDF-15 levels, measured at follow-up, were similarly associated with mortality, and longitudinal measurements of GDF-15 did not significantly differ. Six-year survival probability of patients above vs. below the median GDF-15 level was 44% (95%CI 34-57) and 84% (95%CI 76-93), respectively. The ABC-death score revealed a C-statistic of 0.80. CONCLUSION GDF-15 predicts risk of all-cause mortality and MACE in patients with non-valvular AF. Further, the ABC-death score showed good predictive accuracy in a "real-world" cohort. Therefore, introduction of GDF-15 into clinical practice would enhance risk prediction of morbidity and mortality in AF patients.
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Affiliation(s)
- Stephan Nopp
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Oliver Königsbrügge
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Daniel Kraemmer
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Ingrid Pabinger
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Cihan Ay
- Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
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Ortolá R, García-Esquinas E, Buño-Soto A, Sotos-Prieto M, Struijk EA, Caballero FF, Lopez-Garcia E, Banegas JR, Rodríguez-Artalejo F. Healthy dietary patterns are associated with lower concentrations of growth differentiation factor 15 in older adults. Am J Clin Nutr 2021; 113:1619-1626. [PMID: 33668053 DOI: 10.1093/ajcn/nqaa444] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/21/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Growth differentiation factor 15 (GDF-15) is a biomarker for aging and chronic disease burden that may capture the anti-inflammatory and antioxidant effects attributed to healthy diets. OBJECTIVE The aim was to examine whether several healthy dietary patterns and a lower inflammatory potential of diet are associated with lower concentrations of GDF-15 in older adults. METHODS We used cross-sectional data from 2501 older adults participating in the Seniors-ENRICA-2 study. Four diet indices were derived from habitual food consumption estimated with a validated diet history: Mediterranean Diet Adherence Screener (MEDAS), Alternate Healthy Eating Index-2010 (AHEI-2010), Dietary Approaches to Stop Hypertension (DASH), and Dietary Inflammatory Index (DII). Associations of these indices with GDF-15 concentrations were analyzed using linear regression models and adjusted for risk factors and biomarkers associated with chronic disease. RESULTS There was a clear dose-response association between all dietary patterns and serum GDF-15 concentrations; the GDF-15 mean reductions (95% CI) per 1-SD increment in the diet indices were 1.6% (0.1%, 3.1%) for the MEDAS, 2.1% (0.5%, 3.7%) for the AHEI-2010, and 1.6% (0.1%, 3.2%) for the DASH, whereas a mean GDF-15 increase of 1.7% (0.2%, 3.4%) was observed per 1-SD increment in the DII. In analyses excluding fruit and vegetable components from the diet indices, the association for the MEDAS and the AHEI-2010 remained but was attenuated for the DASH. Analyses excluding participants with cardiovascular disease or diabetes rendered very similar results. CONCLUSIONS A higher adherence to several healthy dietary patterns and a lower inflammatory potential of diet were related to lower concentrations of GDF-15 in older adults, suggesting that improving diet quality may reduce inflammation and possibly promote healthy aging.
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Affiliation(s)
- Rosario Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther García-Esquinas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Antonio Buño-Soto
- Department of Laboratory Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Environmental Health and Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute, Campus of International Excellence Universidad Autónoma de Madrid+Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC) , Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid and Idipaz, Madrid, Spain.,CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMDEA Food Institute, Campus of International Excellence Universidad Autónoma de Madrid+Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC) , Madrid, Spain
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Zhao X, Wang H, Yang Y, Gou Y, Wang Z, Yang D, Li C. Protective Effects of Silymarin Against D-Gal/LPS-Induced Organ Damage and Inflammation in Mice. Drug Des Devel Ther 2021; 15:1903-1914. [PMID: 33976540 PMCID: PMC8106468 DOI: 10.2147/dddt.s305033] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/10/2021] [Indexed: 01/26/2023] Open
Abstract
AIM Silymarin contains various flavonoids and exhibits antioxidative, anti-inflammatory, and anticancer effects, in addition to other pharmacological properties. This study explored the alleviating effect of silymarin on multiple-organ damage induced by D-galactose/lipopolysaccharide in Kunming mice. METHODS Kunming mice were injected intraperitoneally with D-galactose (30 mg/kg·BW)/LPS (3 μg/kg·BW) and then treated using silymarin with different doses (75 mg/kg·bw and 150 mg/kg·bw) via intragastric administration. Changes in organ indexes, pathological changes, liver-function index, biochemical indexes, molecular biological indexes, and genes related to the oxidation and inflammation of main organs were evaluated. RESULTS After the mice were treated with silymarin, their body weight showed no significant change, and the liver, kidney, and lung indexes of the treated mice were higher than those of the model group; meanwhile, the corresponding histopathological formation was reduced. Compared with the model group, the silymarin-treated group showed reductions in ALT, AST, and liver function indexes in the mouse serum. Silymarin treatment also increased the SOD, CAT, GSH, GSH-Px, T-AOC, IL-10, and IL-12 levels, as well as reduced the MDA, NO, IL-6, IL-1β, TNF-α, IFN-γ levels in the mouse serum and liver tissues. In addition, quantitative polymerase chain reaction analysis indicated that the mRNA expression levels of SOD1, SOD2, CAT, GSH-Px, IL-10, Nrf2, HO-1, NQO1, Trx, and IκB-α were higher in the liver tissue of the silymarin-treated mice than in those of the model group; meanwhile, the mRNA expression levels of IL-6, IL-1β, TNF-α, IFN-γ, NF-κB, NLRP3, COX2, and p38 were lower than those in the model group. CONCLUSION Silymarin, which exhibits antioxidative and anti-inflammatory effects, can alleviate the liver, lung, and kidney damage induced by D-galactose/lipopolysaccharide. High-dose (150 mg/kg·bw) silymarin can more effectively inhibit organ damage, compared with low-dose silymarin (75 mg/kg·bw) in Kunming mice.
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Affiliation(s)
- Xin Zhao
- Chongqing Collaborative Innovation Center for Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
- Chongqing Engineering Research Center of Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
- Chongqing Engineering Laboratory for Research and Development of Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
| | - Haoxiang Wang
- Department of Neurology, Second Affiliated Hospital of Army Medical University, Chongqing, 400037, People’s Republic of China
| | - Yue Yang
- Chongqing Collaborative Innovation Center for Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
- College of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
| | - Yuting Gou
- Chongqing Collaborative Innovation Center for Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
- College of Biological and Chemical Engineering, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
| | - Zhiying Wang
- School of Pharmacy, Heilongjiang University of Traditional Chinese Medicine, Harbin, 150040, People’s Republic of China
| | - Dingyi Yang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education (Chongqing University), Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, 400044, People’s Republic of China
| | - Chong Li
- Chongqing Collaborative Innovation Center for Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
- Chongqing Engineering Research Center of Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
- Chongqing Engineering Laboratory for Research and Development of Functional Food, Chongqing University of Education, Chongqing, 400067, People’s Republic of China
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50
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Bao X, Borné Y, Xu B, Orho-Melander M, Nilsson J, Melander O, Engström G. Growth differentiation factor-15 is a biomarker for all-cause mortality but less evident for cardiovascular outcomes: A prospective study. Am Heart J 2021; 234:81-89. [PMID: 33421373 DOI: 10.1016/j.ahj.2020.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/31/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous studies have proposed growth differentiation factor-15 (GDF-15) as a predictor of adverse cardiovascular outcomes and mortality. The present study aimed to determine if such associations remain after accounting for death as a competing risk, and if GDF-15 provides superior prediction performance than other biomarkers. METHODS Plasma GDF-15 levels and cardiovascular risk factors were measured in individuals without cardiovascular diseases (n = 4,143, aged 57.4 ± 5.96 years, 38.6 % men) from Malmö Diet and Cancer-Cardiovascular Cohort and were followed up for more than 20 years. Incidence of coronary events, ischemic stroke, cardiovascular mortality, and all-cause mortality was studied in relation to GDF-15 using Cox proportional hazards regression, with adjustment for potential confounders. Confounding from death as competing risk was carefully checked using the Fine and Gray subdistribution hazard model. Predictive capabilities were further evaluated using C-statistics, continuous net reclassification improvement, and integrated discrimination improvement. RESULTS During follow-up, 424 coronary events, 327 ischemic stroke, 368 cardiovascular deaths, and 1,308 all-cause deaths occurred. After controlling for death from other causes as competing events, only all-cause mortality remained significantly related to GDF-15. The addition of GDF-15 significantly improved prediction for all-cause mortality in addition to the traditional risk factors, high-sensitive C-reactive protein and N-terminal prohormone of brain natriuretic peptide. Only N-terminal prohormone of brain natriuretic peptide improved prediction for CVD mortality. CONCLUSIONS GDF-15 is a robust biomarker for all-cause mortality but less reliable for coronary event, ischemic stroke or cardiovascular mortality. Competing risk from death is an important consideration when interpreting the results.
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Affiliation(s)
- Xue Bao
- Department of Cardiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China; Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Yan Borné
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Biao Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
| | | | - Jan Nilsson
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.
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