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Runco DV, DiMeglio LA, Vanderpool CP, Han Y, Daggy J, Kelley MM, Mikesell R, Zimmers TA. Growth differentiation factor 15 (GDF15) elevation in children with newly diagnosed cancer. Front Oncol 2023; 13:1295228. [PMID: 38146512 PMCID: PMC10749306 DOI: 10.3389/fonc.2023.1295228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023] Open
Abstract
Background Growth differentiation factor 15 (GDF15), an inflammatory marker and mediator of adult cancer cachexia, remains largely unexplored in children. GDF15 increases nausea, vomiting, and anorexia in cancer and contributes to malnutrition, with the potential to be a cachexia therapeutic target. No studies have examined GDF15 in children with newly diagnosed cancer. Our pilot study compares GDF15 in children with newly diagnosed cancer to age- and sex-matched controls and correlates levels with anthropometric measurements and quality of life (QOL). Methods Children with newly diagnosed cancer aged 2-21 years were enrolled with serum GDF15 ELISA, anthropometric measures [height, weight, and mid-upper arm circumference (MUAC)], and QOL assessments (using PedsQL™ Core and Gastrointestinal Modules), which were collected at baseline and repeated 3 months later. Serum GDF15 levels were obtained from age- and sex-matched controls for comparison. Results A total of 57 participants enrolled (N=30, cancer group; N=27, control group) with a median age of 8.8 years (IQR 5.6-15.9 years). The participants were primarily male (54.4%), white (82.5%), and non-Hispanic (82.5%). Cancer diagnoses included acute lymphoblastic leukemia (N=8), lymphoma (N=8), neuroblastoma (N=5), soft tissue tumors (N=4), acute myeloid leukemia (N=2), and single participants with brain, kidney, and bone tumors. Baseline GDF15 was higher in the cancer cohort compared to the control cohort (median=614.6pg/mL and 320.5pg/mL, respectively; p<0.001). When examining participants with evaluable baseline and 3-month follow-up GDF15 levels (N=18), GDF15 was not statistically different (median=657.1pg/mL and 675.3pg/mL, respectively; p=0.702). A total of 13 of the 30 participants and 21 caregivers completed the PedsQL™ Core and Gastrointestinal symptom modules. QOL scores did not differ significantly at 3-month follow-up compared to baseline, but diarrhea worsened (p=0.017). Median participant response for diarrhea at baseline was 92.9 (IQR=92.9-96.4; N=13), which was significantly better than the follow-up (median=78.6; IQR= 71.4-92.9; p=0.017). There were no correlations between change in height, weight, or MUAC and change in GDF15 levels (p=0.351, 0.920, and 0.269 respectively). Conclusion GDF15 was elevated in children with cancer at diagnosis compared to controls but did not correlate with anthropometric measurements or QOL. This pilot study will inform future prospective studies to better describe the natural history of GDF15 and its role in cachexia and as a potential therapeutic target.
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Affiliation(s)
- Daniel V. Runco
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Linda A. DiMeglio
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
- Division of Pediatric Endocrinology and Diabetology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Charles P. Vanderpool
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
- Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Yan Han
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Joanne Daggy
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Mary M. Kelley
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Raya Mikesell
- Department of Pediatrics, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, United States
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Teresa A. Zimmers
- Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, IN, United States
- Department of Cell, Developmental and Cancer Biology, Knight Cancer Institute, Oregon Health and Science University, Portland, OR, United States
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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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3
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Growth differentiation factor 15 (GDF-15) in kidney diseases. Adv Clin Chem 2023. [DOI: 10.1016/bs.acc.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Welsh P, Kimenai DM, Marioni RE, Hayward C, Campbell A, Porteous D, Mills NL, O’Rahilly S, Sattar N. Reference ranges for GDF-15, and risk factors associated with GDF-15, in a large general population cohort. Clin Chem Lab Med 2022; 60:1820-1829. [PMID: 35976089 PMCID: PMC9524804 DOI: 10.1515/cclm-2022-0135] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/01/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Growth differentiation factor (GDF)-15 is attracting interest as a biomarker in several areas of medicine. We aimed to evaluate the reference range for GDF-15 in a general population, and to explore demographics, classical cardiovascular disease risk factors, and other cardiac biomarkers associated with GDF-15. METHODS GDF-15 was measured in serum from 19,462 individuals in the Generation Scotland Scottish Family Health Study. Associations of cardiometabolic risk factors with GDF-15 were tested using adjusted linear regression. Among 18,507 participants with no heart disease, heart failure, or stroke, and not pregnant, reference ranges (median and 97.5th centiles) were derived by decade age bands and sex. RESULTS Among males in the reference range population, median (97.5th centile) GDF-15 concentration at age <30 years was 537 (1,135) pg/mL, rising to 931 (2,492) pg/mL at 50-59 years, and 2,152 (5,972) pg/mL at ≥80 years. In females, median GDF-15 at age <30 years was 628 (2,195) pg/mL, 881 (2,323) pg/mL at 50-59 years, and 1847 (6,830) pg/mL at ≥80 years. Among those known to be pregnant, median GDF-15 was 19,311 pg/mL. After adjustment, GDF-15 was higher in participants with adverse cardiovascular risk factors, including current smoking (+26.1%), those with previous heart disease (+12.7%), stroke (+17.1%), heart failure (+25.3%), and particularly diabetes (+60.2%). GDF-15 had positive associations with cardiac biomarkers cardiac troponin I, cardiac troponin T, and N-terminal pro B-type natriuretic peptide (NT-proBNP). CONCLUSIONS These data define reference ranges for GDF-15 for comparison in future studies, and identify potentially confounding risk factors and mediators to be considered in interpreting GDF-15 concentrations.
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Affiliation(s)
- Paul Welsh
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
| | - Dorien M. Kimenai
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Riccardo E. Marioni
- Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, UK
| | - Caroline Hayward
- MRC Human Genetics Unit (HGU), University of Edinburgh, Edinburgh, UK
| | - Archie Campbell
- Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, UK
| | - David Porteous
- Institute of Genetics and Cancer (IGC), University of Edinburgh, Edinburgh, UK
| | - Nicholas L. Mills
- BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Stephen O’Rahilly
- MRC Metabolic Diseases Unit, Wellcome – MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Naveed Sattar
- School of Cardiovascular & Metabolic Health, University of Glasgow, Glasgow, UK
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Altilia M, Braga F, Capoferri A, Panteghini M. Biological variation of serum cholinesterase catalytic concentrations. Clin Chem Lab Med 2022; 60:e177-e180. [PMID: 35561807 DOI: 10.1515/cclm-2022-0346] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/29/2022] [Indexed: 11/15/2022]
Affiliation(s)
- Mariangela Altilia
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), Università Degli Studi di Milano, Milan, Italy
| | - Federica Braga
- UOC Patologia Clinica, ASST Fatebenefratelli-Sacco, Via GB Grassi 74, 20157, Milan, Italy
| | - Alessia Capoferri
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), Università Degli Studi di Milano, Milan, Italy
| | - Mauro Panteghini
- Research Centre for Metrological Traceability in Laboratory Medicine (CIRME), Università Degli Studi di Milano, Milan, Italy
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Sithiravel C, Røysland R, Alaour B, Sylte MS, Torsvik J, Strand H, Marber M, Omland T, Aakre KM. Biological variation, reference change values and index of individuality of GDF-15. Clin Chem Lab Med 2021; 60:593-596. [PMID: 34644816 PMCID: PMC8997700 DOI: 10.1515/cclm-2021-0769] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/21/2021] [Indexed: 01/11/2023]
Affiliation(s)
- Cindhya Sithiravel
- Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital, Lørenskog, Norway
| | - Ragnhild Røysland
- Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bashir Alaour
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
| | | | - Janniche Torsvik
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
| | - Heidi Strand
- Multidisciplinary Laboratory Medicine and Medical Biochemistry, Akershus University Hospital, Lørenskog, Norway
| | - Michael Marber
- School of Cardiovascular Medicine and Sciences, King’s College London, London, UK
| | - Torbjørn Omland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Kristin Moberg Aakre
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
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Barton H, Zechendorf E, Ostareck D, Ostareck-Lederer A, Stoppe C, Zayat R, Simon-Philipp T, Marx G, Bickenbach J. Prognostic Value of GDF-15 in Predicting Prolonged Intensive Care Stay following Cardiac Surgery: A Pilot Study. DISEASE MARKERS 2021; 2021:5564334. [PMID: 34221186 PMCID: PMC8221876 DOI: 10.1155/2021/5564334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/05/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Predicting intensive care unit length of stay and outcome following cardiac surgery is currently based on clinical parameters. Novel biomarkers could be employed to improve the prediction models. MATERIALS AND METHODS We performed a qualitative cytokine screening array to identify highly expressed biomarkers in preoperative blood samples of cardiac surgery patients. After identification of one highly expressed biomarker, growth differentiation factor 15 (GDF-15), a quantitative ELISA was undertaken. Preoperative levels of GDF-15 were compared in regard to duration of intensive care stay, cardiopulmonary bypass time, and indicators of organ dysfunction. RESULTS Preoperatively, GDF-15 was highly expressed in addition to several less highly expressed other biomarkers. After qualitative analysis, we could show that preoperatively raised levels of GDF-15 were positively associated with prolonged ICU stay exceeding 48 h (median 713 versus 1041 pg/ml, p = 0.003). It was also associated with prolonged mechanical ventilation and rates of severe sepsis but not with dialysis rates or cardiopulmonary bypass time. In univariate regression, raised GDF-15 levels were predictive of a prolonged ICU stay (OR 1.01, 95% confidence interval 1-1.02, and p = 0.029). On ROC curves, GDF-15 was found to predict prolonged ICU stay (AUC = 0.86, 95% confidence interval 0.71-0.99, and p = 0.003). CONCLUSION GDF-15 showed potential as predictor of prolonged intensive care stay following cardiac surgery, which might be valuable for risk stratification models.
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Affiliation(s)
- Henry Barton
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Elisabeth Zechendorf
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Dirk Ostareck
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Antje Ostareck-Lederer
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Christian Stoppe
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Rashad Zayat
- Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Tim Simon-Philipp
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Gernot Marx
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
| | - Johannes Bickenbach
- Department of Surgical Intensive Medicine and Intermediate Care, University Hospital RWTH Aachen, Aachen, Pauwelstrasse 30, 52074 Aachen, Germany
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Tavenier J, Andersen O, Nehlin JO, Petersen J. Longitudinal course of GDF15 levels before acute hospitalization and death in the general population. GeroScience 2021; 43:1835-1849. [PMID: 33763774 DOI: 10.1007/s11357-021-00359-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/19/2021] [Indexed: 11/29/2022] Open
Abstract
Growth differentiation 15 (GDF15) is a potential novel biomarker of biological aging. To separate the effects of chronological age and birth cohort from biological age, longitudinal studies investigating the associations of GDF15 levels with adverse health outcomes are needed. We investigated changes in GDF15 levels over 10 years in an age-stratified sample of the general population and their relation to the risk of acute hospitalization and death. Serum levels of GDF15 were measured three times in 5-year intervals in 2176 participants aged 30, 40, 50, or 60 years from the Danish population-based DAN-MONICA cohort. We assessed the association of single and repeated GDF15 measurements with the risk of non-traumatic acute hospitalizations. We tested whether changes in GDF15 levels over 10 years differed according to the frequency of hospitalizations within 2 years or survival within 20 years, after the last GDF15 measurement. The change in GDF15 levels over time was dependent on age and sex. Higher GDF15 levels and a greater increase in GDF15 levels were associated with an increased risk of acute hospitalization in adjusted Cox regression analyses. Participants with more frequent admissions within 2 years, and those who died within 20 years, after the last GDF15 measurement already had elevated GDF15 levels at baseline and experienced greater increases in GDF15 levels during the study. The change in GDF15 levels was associated with changes in C-reactive protein and biomarkers of kidney, liver, and cardiac function. Monitoring of GDF15 starting in middle-aged could be valuable for the prediction of adverse health outcomes.
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Affiliation(s)
- Juliette Tavenier
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, DK-2650, Hvidovre, Denmark.
| | - Ove Andersen
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, DK-2650, Hvidovre, Denmark.,Emergency Department, Copenhagen University Hospital Amager and Hvidovre, Kettegaard Alle 30, 2650, Hvidovre, Denmark.,Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
| | - Jan O Nehlin
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, DK-2650, Hvidovre, Denmark
| | - Janne Petersen
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, DK-2650, Hvidovre, Denmark.,Center for Clinical Research and Prevention, Copenhagen University Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
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Stojanovic D, Mitic V, Stojanovic M, Petrovic D, Ignjatovic A, Stefanovic N, Cvetkovic T, Kocic G, Bojanic V, Deljanin Ilic M. The partnership between renalase and ejection fraction as a risk factor for increased cardiac remodeling biomarkers in chronic heart failure patients. Curr Med Res Opin 2020; 36:909-919. [PMID: 32297799 DOI: 10.1080/03007995.2020.1756233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective: Heart failure (HF) represents a huge socio-economic burden. It has been demonstrated, experimentally, that renalase, a newly discovered protein, prevents cardiac hypertrophy and adverse remodeling, which is seen in HF. We postulated the following aims: to investigate associations of renalase with biomarkers of cardiac remodeling: galectin-3, soluble suppression of tumorigenicity, (sST2), growth differentiation factor 15 (GDF-15) and syndecan-1, myocardial stretch (BNP) and cardio-renal axis (cystatin C) in HF patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF) to determine whether renalase, in combination with left ventricular ejection fraction (LVEF), represents a risk factor for plasma elevation in biomarkers.Methods: We classified HF patients (n = 76) according to LVEF (preserved/reduced), applied a median plasma renalase (113 ng/mL) as a cut-off value (low/high) and created four subgroups of HF patients: HFpEF/low renalase (n = 19), HFrEF/low renalase (n = 19), HFrEF/high renalase (n = 32) and HFpEF/high renalase (n = 6). A control group (n = 35) consisted of healthy volunteers.Results: Plasma concentrations of evaluated biomarkers were determined using an ELISA technique and were highest in HF patients with reduced EF (p < .001, respectively), and renalase's positive correlations were obtained relating to all biomarkers: galectin-3 (r = 0.913; p < .001), sST2 (r = 0.965; p < .001), GDF-15 (r = 0.887; p < .001), syndecan-1 (r = 0.922; p < .001), BNP (r = 0.527; p < .001) and cystatin C (r = 0.844; p < .001) and strong and negative correlation with LVEF (r = -0.456, p < .001). Increased renalase, regardless of the EF (preserved/reduced), was shown to be an independent risk factor for an increase in all evaluated cardiac remodeling biomarkers, p < .001, respectively. However, increased renalase and reduced EF was the only independent risk factor for BNP and cystatin C elevation, p < .001, respectively. Results after multivariable adjustments (age/gender) were identical.Conclusion: When elevated plasma renalase and HF are present, regardless of EF being reduced or preserved, that represents a significant risk factor for increase in cardiac remodeling biomarker plasma concentrations. However, only elevated renalase and reduced EF demonstrated significance as a risk factor for BNP and cystatin C plasma elevation. Renalase may be considered a promising molecule for the improved predictive abilities of conventional biomarkers and is worthy of further investigation.
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Affiliation(s)
- Dijana Stojanovic
- Faculty of Medicine, Institute of Pathophysiology, University of Nis, Nis, Serbia
| | - Valentina Mitic
- Institute for Treatment and Rehabilitation "Niska Banja", Niška Banja, Serbia
| | - Miodrag Stojanovic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Nis, Nis, Serbia
- Institute for Public Health, Nis, Serbia
| | - Dejan Petrovic
- Institute for Treatment and Rehabilitation "Niska Banja", Niška Banja, Serbia
- Department of Internal Medicine, Faculty of Medicine, University of Nis, Nis, Serbia
| | - Aleksandra Ignjatovic
- Department of Medical Statistics and Informatics, Faculty of Medicine, University of Nis, Nis, Serbia
- Institute for Public Health, Nis, Serbia
| | - Nikola Stefanovic
- Department of Pharmacy, Faculty of Medicine, University of Nis, Nis, Serbia
| | - Tatjana Cvetkovic
- Faculty of Medicine, Institute of Biochemistry, University of Nis, Nis, Serbia
| | - Gordana Kocic
- Faculty of Medicine, Institute of Biochemistry, University of Nis, Nis, Serbia
| | - Vladmila Bojanic
- Faculty of Medicine, Institute of Pathophysiology, University of Nis, Nis, Serbia
| | - Marina Deljanin Ilic
- Institute for Treatment and Rehabilitation "Niska Banja", Niška Banja, Serbia
- Department of Internal Medicine, Faculty of Medicine, University of Nis, Nis, Serbia
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Nakajima T, Shibasaki I, Sawaguchi T, Haruyama A, Kaneda H, Nakajima T, Hasegawa T, Arikawa T, Obi S, Sakuma M, Ogawa H, Toyoda S, Nakamura F, Abe S, Fukuda H, Inoue T. Growth Differentiation Factor-15 (GDF-15) is a Biomarker of Muscle Wasting and Renal Dysfunction in Preoperative Cardiovascular Surgery Patients. J Clin Med 2019; 8:jcm8101576. [PMID: 31581569 PMCID: PMC6832285 DOI: 10.3390/jcm8101576] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 09/22/2019] [Accepted: 09/25/2019] [Indexed: 12/12/2022] Open
Abstract
Frailty and sarcopenia increase the risk of complications and mortality when invasive treatment such as cardiac surgery is performed. Growth differentiation factor-15 (GDF-15) involves various pathophysiological conditions including renal dysfunction, heart failure and cachexia. We investigated the pathophysiological roles of preoperative GDF-15 levels in cardiovascular surgery patients. Preoperative skeletal muscle index (SMI) determined by bioelectrical impedance analysis, hand-grip strength, 4 m gait speed, and anterior thigh muscle thickness (TMth) measured by echocardiography were assessed in 72 patients (average age 69.9 years) who underwent cardiovascular surgery. The preoperative serum GDF-15 concentration was determined by enzyme-linked immunosorbent assay. Circulating GDF-15 level was correlated with age, brain natriuretic peptide, and estimated glomerular filtration rate (eGFR). It was also negatively correlated with SMI, hand-grip strength, and anterior TMth. In multivariate analysis, eGFR and anterior TMth were the independent determinants of GDF-15 concentration even after adjusting for age, sex, and body mass index. Alternatively, the GDF-15 level was an independent determinant of eGFR and anterior TMth. We concluded that preoperative GDF-15 levels reflect muscle wasting as well as renal dysfunction in preoperative cardiovascular surgery patients. GDF-15 may be a novel biomarker for identify high-risk patients with muscle wasting and renal dysfunction before cardiovascular surgery.
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Affiliation(s)
- Toshiaki Nakajima
- 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.
| | - Tatsuya Sawaguchi
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Akiko Haruyama
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Hiroyuki Kaneda
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Takafumi Nakajima
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Takaaki Hasegawa
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Takuo Arikawa
- 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.
| | - Masashi Sakuma
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Hironaga Ogawa
- Department of Cardiovascular Surgery, 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.
| | - Fumitaka Nakamura
- Third Department of Internal Medicine, Teikyo University, Chiba Medical Center, Ichihara, Chiba 299-0111, Japan.
| | - Shichiro Abe
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Hirotsugu Fukuda
- Department of Cardiovascular Surgery, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
| | - Teruo Inoue
- Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
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Berezin AE. Prognostication of clinical outcomes in diabetes mellitus: Emerging role of cardiac biomarkers. Diabetes Metab Syndr 2019; 13:995-1003. [PMID: 31336558 DOI: 10.1016/j.dsx.2019.01.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Accepted: 01/17/2019] [Indexed: 02/06/2023]
Abstract
Type 2 diabetes mellitus (T2DM) remains substantial health problem and one of the most prevalent metabolic diseases worldwide. The impact of T2DM on CV mortality and morbidity is embedded through a nature evolution of the disease and is modulated by numerous risk factors, such as hypertension, obesity, dyslipidemia. There is large body of evidence regarding use of the cardiac biomarkers to risk stratification at higher CV risk individuals who belongs to general population and cohort with established CV disease. Although T2DM patients have higher incidence of cardiac and vascular complications than the general population, whether cardiac biomarkers would be effective to risk stratification of the T2DM is not fully understood. The aim of the review is to summarize our knowledge regarding clinical implementation of cardiac biomarkers in risk assessment for T2DM patients. The role of natriuretic peptides, soluble ST2, galectin-3, growth differentiation factor-15, and cardiac troponins are widely discussed.
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Affiliation(s)
- Alexander E Berezin
- Internal Medicine Department, Medical University of Zaporozhye, Mayakovsky av., 25, Zaporozhye, 69035, Ukraine.
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