GDF-15 can predict heart failure risk, especially in diabetes patients: Study
USA: Growth differentiation factor-15 (GDF-15) provides complementary prognostic information on the risk of heart failure (HF), particularly among people with diabetes, says a recent study in Diabetologia. The researchers however add that it is not clear to which extent GDF-15 is associated with HF among people with and without diabetes.
Elevated circulating growth differentiation factor-15, a marker of cellular stress, is shown to be associated with both diabetes and heart failure. However, to what extent GDF-15 is associated with HF among individuals with and without diabetes is not clear.
Justin B. Echouffo-Tcheugui, Johns Hopkins University School of Medicine, Baltimore, MD, USA, and colleagues evaluated 10,570 participants free of HF at Visit 3 (1993–1995) of the Atherosclerosis Risk in Communities study.
The researchers used Cox regression for evaluating the joint associations of GDF-15 and diabetes with incident HF. Adjustment of models was sone for traditional cardiovascular risk factors.
Salient findings of the study include:
- Among a total of 10,570 individuals (mean age of 60.0 years, 54% women, 27% black adults), elevated GDF-15 (≥75th percentile) was more common in people with diabetes compared with those without diabetes (32.8% vs 23.6%).
- During 23 years of follow-up, there were 2429 incident HF events.
- GDF-15 (in quartiles) was independently associated with HF among those with and without diabetes, with a stronger association among individuals with diabetes: HR for the highest vs lowest GDF-15 quartile (reference): 1.64 among those without diabetes and 1.72 among those with diabetes.
- Individuals with diabetes and elevated GDF-15 had the highest risk of incident HF (HR 2.46).
- After accounting for HF risk factors, GDF-15 provided additional prognostic information among participants with diabetes (ΔC statistic for model with vs model without GDF-15: +0.008) and among those without diabetes (+0.006).
"GDF-15 provided complementary prognostic information on the HF risk, especially among individuals with diabetes in a community-based sample of US adults," the authors concluded.
Reference:
Echouffo-Tcheugui, J.B., Daya, N., Ndumele, C.E. et al. Diabetes, GDF-15 and incident heart failure: the atherosclerosis risk in communities study. Diabetologia 65, 955–963 (2022). https://doi.org/10.1007/s00125-022-05678-6
