Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease
Background: Growth differentiation factor 15 (GDF-15) is a robust prognostic biomarker in patients with cardiovascular (CV) disease, and a better understanding of its clinical determinants is desirable. We aimed to study the associations between GDF-15 levels and traditional CV risk factors, indicat...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Upsala Medical Society
2024-12-01
|
| Series: | Upsala Journal of Medical Sciences |
| Subjects: | |
| Online Access: | https://ujms.net/index.php/ujms/article/view/11001/18551 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841554660317462528 |
|---|---|
| author | Emma Skau Philippe Wagner Jerzy Leppert Johan Ärnlöv Pär Hedberg |
| author_facet | Emma Skau Philippe Wagner Jerzy Leppert Johan Ärnlöv Pär Hedberg |
| author_sort | Emma Skau |
| collection | DOAJ |
| description | Background: Growth differentiation factor 15 (GDF-15) is a robust prognostic biomarker in patients with cardiovascular (CV) disease, and a better understanding of its clinical determinants is desirable. We aimed to study the associations between GDF-15 levels and traditional CV risk factors, indicators of atherosclerotic burden, and cardiac geometry and dysfunction in outpatients with peripheral arterial disease (PAD). Methods: An explorative cross-sectional study (Study of Atherosclerosis in Vastmanland, Västerås, Sweden) included 439 outpatients with carotid or lower extremity PAD. The mean age was 70 years (standard deviation [SD] 7), and 59% of the patients were men. Plasma levels of GDF-15 were obtained along with potential determinants, including medical history, biochemical data, echocardiographic measures of cardiac geometry and function, ankle-brachial index (ABI), and carotid ultrasonographic data on intima-media thickness (IMT) and occurrence of carotid stenosis. The relations between GDF-15 concentrations (transformed with the natural logarithm) and the different determinants were evaluated using uni- and multivariable linear regression models. All pre-specified variables were included in the multivariable models. Results: The multivariable analysis identified independent relations of GDF-15 with several of the included variables (adjusted R2 = 0.48). Diabetes (beta coefficient [β] of 0.37, 95% confidence interval [95% CI] 0.25 to 0.50), low-density lipoprotein (LDL) cholesterol (β = −0.22, 95% confidence interval [CI]: −0.34 to −0.09), and physical activity (β = −0.16, 95% CI: −0.25 to −0.06) had the strongest associations. In contrast, no significant independent associations with GDF-15 level were observed for cardiac geometry and function, ABI, IMT, or carotid stenosis. Conclusions: Circulating GDF-15 is more strongly associated with traditional CV risk factors, especially diabetes, LDL cholesterol, and physical activity than with specific indicators of atherosclerotic burden or cardiac dysfunction. To better understand the pathophysiological role of GDF-15 and its link to clinical outcomes in patients with PAD, future studies should focus on the metabolic processes involved in atherosclerotic disease. |
| format | Article |
| id | doaj-art-c5a30bfbe33a45149f0f953c6b7940bb |
| institution | Kabale University |
| issn | 0300-9734 2000-1967 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Upsala Medical Society |
| record_format | Article |
| series | Upsala Journal of Medical Sciences |
| spelling | doaj-art-c5a30bfbe33a45149f0f953c6b7940bb2025-01-08T11:27:23ZengUpsala Medical SocietyUpsala Journal of Medical Sciences0300-97342000-19672024-12-011291910.48101/ujms.v129.1100111001Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial diseaseEmma Skau0Philippe Wagner1Jerzy Leppert2Johan Ärnlöv3Pär Hedberg4Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, SwedenCentre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, SwedenCentre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, SwedenSchool of Health and Social Studies, Dalarna University, Falun, SwedenCentre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, SwedenBackground: Growth differentiation factor 15 (GDF-15) is a robust prognostic biomarker in patients with cardiovascular (CV) disease, and a better understanding of its clinical determinants is desirable. We aimed to study the associations between GDF-15 levels and traditional CV risk factors, indicators of atherosclerotic burden, and cardiac geometry and dysfunction in outpatients with peripheral arterial disease (PAD). Methods: An explorative cross-sectional study (Study of Atherosclerosis in Vastmanland, Västerås, Sweden) included 439 outpatients with carotid or lower extremity PAD. The mean age was 70 years (standard deviation [SD] 7), and 59% of the patients were men. Plasma levels of GDF-15 were obtained along with potential determinants, including medical history, biochemical data, echocardiographic measures of cardiac geometry and function, ankle-brachial index (ABI), and carotid ultrasonographic data on intima-media thickness (IMT) and occurrence of carotid stenosis. The relations between GDF-15 concentrations (transformed with the natural logarithm) and the different determinants were evaluated using uni- and multivariable linear regression models. All pre-specified variables were included in the multivariable models. Results: The multivariable analysis identified independent relations of GDF-15 with several of the included variables (adjusted R2 = 0.48). Diabetes (beta coefficient [β] of 0.37, 95% confidence interval [95% CI] 0.25 to 0.50), low-density lipoprotein (LDL) cholesterol (β = −0.22, 95% confidence interval [CI]: −0.34 to −0.09), and physical activity (β = −0.16, 95% CI: −0.25 to −0.06) had the strongest associations. In contrast, no significant independent associations with GDF-15 level were observed for cardiac geometry and function, ABI, IMT, or carotid stenosis. Conclusions: Circulating GDF-15 is more strongly associated with traditional CV risk factors, especially diabetes, LDL cholesterol, and physical activity than with specific indicators of atherosclerotic burden or cardiac dysfunction. To better understand the pathophysiological role of GDF-15 and its link to clinical outcomes in patients with PAD, future studies should focus on the metabolic processes involved in atherosclerotic disease.https://ujms.net/index.php/ujms/article/view/11001/18551atherosclerosisbiomarkergdf-15peripheral arterial diseasediabetes |
| spellingShingle | Emma Skau Philippe Wagner Jerzy Leppert Johan Ärnlöv Pär Hedberg Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease Upsala Journal of Medical Sciences atherosclerosis biomarker gdf-15 peripheral arterial disease diabetes |
| title | Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease |
| title_full | Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease |
| title_fullStr | Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease |
| title_full_unstemmed | Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease |
| title_short | Determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease |
| title_sort | determinants of growth differentiation factor 15 plasma levels in outpatients with peripheral arterial disease |
| topic | atherosclerosis biomarker gdf-15 peripheral arterial disease diabetes |
| url | https://ujms.net/index.php/ujms/article/view/11001/18551 |
| work_keys_str_mv | AT emmaskau determinantsofgrowthdifferentiationfactor15plasmalevelsinoutpatientswithperipheralarterialdisease AT philippewagner determinantsofgrowthdifferentiationfactor15plasmalevelsinoutpatientswithperipheralarterialdisease AT jerzyleppert determinantsofgrowthdifferentiationfactor15plasmalevelsinoutpatientswithperipheralarterialdisease AT johanarnlov determinantsofgrowthdifferentiationfactor15plasmalevelsinoutpatientswithperipheralarterialdisease AT parhedberg determinantsofgrowthdifferentiationfactor15plasmalevelsinoutpatientswithperipheralarterialdisease |