Association of growth and differentiation factor-15 with coronary artery calcium score
and ankle-brachial index in a middle-aged and elderly Caucasian population sample
free of manifest cardiovascular disease
(Open access funding provided by Semmelweis University)
(NVKP-16-1-2016-0017 National Heart Program) Támogató: NKFIH
János Bolyai Research Scholarship of the Hungarian Academy of Sciences(TKP2021-NVA-15)
(RRF-2.3.1-21-2022-00003)
Szakterületek:
Szív és keringési rendszer
Growth and differentiation factor-15 (GDF-15) is a stress-associated cytokine of the
transforming growth factor-β superfamily. The inflammatory and angiogenic effects
of GDF-15 in atherosclerosis are controversial, and its correlation with the long
asymptomatic phase of the disease is not well understood. Coronary artery calcium
score (CACS) and ankle-brachial index (ABI) are sensitive markers of subclinical atherosclerosis.
To date, only a few studies have examined the impact of GDF-15 on coronary artery
calcification, and the association between GDF-15 and ABI has not been evaluated.
Therefore, we aimed to investigate the possible relationship between serum GDF-15
concentrations and CACS and ABI in a Caucasian population sample of middle-aged (35-65
years) and elderly (> 65 years) people. In addition to recording demographic and anthropometric
characteristics, atherosclerotic risk factors, and laboratory tests including serum
HDL-cholesterol, LDL-cholesterol, hemoglobin A1c (HbA1c), high-sensitivity C-reactive
protein, and N-terminal pro-B-type natriuretic peptide (NT-proBNP); GDF-15 level,
cardiac computed tomography, and ABI measurements were also performed. A total of
269 asymptomatic individuals (men, n = 125; median age, 61.5 [IQR, 12.7] years) formed
the basis of this study. Participants were divided into two groups according to their
age (middle-aged, n = 175 and elderly, n = 94). Hypertension and diabetes mellitus
were significantly more prevalent and CACS values and HbA1c, NT-proBNP, and GDF-15
levels were significantly higher (all p < 0.001) in the elderly group compared to
the middle-aged group. Multivariate ridge regression analysis revealed a significant
positive association between GDF-15 and CACS (middle-aged group: β = 0.072, p = 0.333;
elderly group: β = 0.148, p = 0.003), and between GDF-15 and ABI (middle-aged group:
β = 0.062, p = 0.393; elderly group: β = 0.088, p = 0.041) only in the elderly group.
Our results show that GDF-15 is not only a useful biomarker of inflammation but can
also predict early signs of asymptomatic atherosclerosis, especially in elderly people
with chronic systemic inflammation associated with aging (inflammaging).
