Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysis

Abstract Growth-differentiation factor 15 (GDF-15) is a cytokine involved in cellular stress responses and inflammation. This meta-analysis evaluates the association between circulating GDF-15 levels and functional outcomes in patients with acute ischemic stroke (AIS). A comprehensive search of Medl...

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Main Authors: Yulang Wu, Yude Wei, Jinrong He, Fengkun Zhou
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Head & Face Medicine
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Online Access:https://doi.org/10.1186/s13005-024-00476-4
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author Yulang Wu
Yude Wei
Jinrong He
Fengkun Zhou
author_facet Yulang Wu
Yude Wei
Jinrong He
Fengkun Zhou
author_sort Yulang Wu
collection DOAJ
description Abstract Growth-differentiation factor 15 (GDF-15) is a cytokine involved in cellular stress responses and inflammation. This meta-analysis evaluates the association between circulating GDF-15 levels and functional outcomes in patients with acute ischemic stroke (AIS). A comprehensive search of Medline, Web of Science, Embase, Wanfang, and CNKI was conducted up to July 15, 2024. Observational studies with longitudinal follow-up that measured GDF-15 levels within 24 h of stroke onset and reported functional outcomes, defined as a modified Rankin Scale (mRS) score of ≥ 2, were included. Odds ratios (OR) with 95% confidence intervals (CI) were used to quantify associations. Heterogeneity was evaluated using I² statistics, and a random-effects model was used to pool the results by incorporating the influence of heterogeneity. Ten studies involving 4,231 patients were included. The pooled OR indicated that high circulating GDF-15 levels were associated with a significantly higher risk of poor functional outcomes at 3 months (OR: 2.60, 95% CI: 1.95 to 3.46, p < 0.001). Sensitivity analyses by excluding one study at a time did not significantly change the results. Subgroup analyses revealed stronger associations in studies with GDF-15 cutoff values < 1200 ng/L as compared to ≥ 1200 ng/L, and in those defining poor outcomes as mRS ≥ 3 as compared to those ≥ 2. In conclusion, elevated circulating GDF-15 levels are associated with worse functional outcomes following AIS. These findings support the potential use of GDF-15 as a prognostic biomarker in stroke patients. Further research is warranted to confirm these results and explore clinical applications.
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spelling doaj-art-3693f3f847ed455697b48cd443da76b02025-08-20T02:39:38ZengBMCHead & Face Medicine1746-160X2024-12-0120111310.1186/s13005-024-00476-4Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysisYulang Wu0Yude Wei1Jinrong He2Fengkun Zhou3The Second Department of Neurology, The First People’s Hospital of NanningThe Second Department of Neurology, The First People’s Hospital of NanningThe Second Department of Neurology, The First People’s Hospital of NanningThe Second Department of Neurology, The First People’s Hospital of NanningAbstract Growth-differentiation factor 15 (GDF-15) is a cytokine involved in cellular stress responses and inflammation. This meta-analysis evaluates the association between circulating GDF-15 levels and functional outcomes in patients with acute ischemic stroke (AIS). A comprehensive search of Medline, Web of Science, Embase, Wanfang, and CNKI was conducted up to July 15, 2024. Observational studies with longitudinal follow-up that measured GDF-15 levels within 24 h of stroke onset and reported functional outcomes, defined as a modified Rankin Scale (mRS) score of ≥ 2, were included. Odds ratios (OR) with 95% confidence intervals (CI) were used to quantify associations. Heterogeneity was evaluated using I² statistics, and a random-effects model was used to pool the results by incorporating the influence of heterogeneity. Ten studies involving 4,231 patients were included. The pooled OR indicated that high circulating GDF-15 levels were associated with a significantly higher risk of poor functional outcomes at 3 months (OR: 2.60, 95% CI: 1.95 to 3.46, p < 0.001). Sensitivity analyses by excluding one study at a time did not significantly change the results. Subgroup analyses revealed stronger associations in studies with GDF-15 cutoff values < 1200 ng/L as compared to ≥ 1200 ng/L, and in those defining poor outcomes as mRS ≥ 3 as compared to those ≥ 2. In conclusion, elevated circulating GDF-15 levels are associated with worse functional outcomes following AIS. These findings support the potential use of GDF-15 as a prognostic biomarker in stroke patients. Further research is warranted to confirm these results and explore clinical applications.https://doi.org/10.1186/s13005-024-00476-4Ischemic strokeGrowth-differentiation factor 15Functional outcomePredictorMeta-analysis
spellingShingle Yulang Wu
Yude Wei
Jinrong He
Fengkun Zhou
Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysis
Head & Face Medicine
Ischemic stroke
Growth-differentiation factor 15
Functional outcome
Predictor
Meta-analysis
title Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysis
title_full Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysis
title_fullStr Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysis
title_full_unstemmed Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysis
title_short Circulating level of growth-differentiation factor 15 and the functional outcome after acute ischemic stroke: a systematic review and meta-analysis
title_sort circulating level of growth differentiation factor 15 and the functional outcome after acute ischemic stroke a systematic review and meta analysis
topic Ischemic stroke
Growth-differentiation factor 15
Functional outcome
Predictor
Meta-analysis
url https://doi.org/10.1186/s13005-024-00476-4
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