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Age Ageing. 2019 Mar 11. pii: afz022. doi: 10.1093/ageing/afz022. [Epub ahead of print]

Association of growth differentiation factor 15 with other key biomarkers, functional parameters and mortality in community-dwelling older adults.

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Institute of Epidemiology and Medical Biometry, Ulm University, D-89081 Ulm, Germany.
Agaplesion Bethesda Hospital, Geriatric Research Unit, Ulm University and Geriatric Center Ulm/Alb-Donau, 89073 Ulm, Germany.
Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, 89081 Ulm, Germany.
Deutsches Herzzentrum München, Technische Universität München, 80636 Munich, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Technische Universität München, 80636 Munich, Germany.
Department of Geriatrics and Geriatric Rehabilitation, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.
IB Hochschule Berlin, Studienzentrum Stuttgart, 70178 Stuttgart, Germany.



Growth differentiation factor 15 (GDF-15) has been associated with many adverse age-related outcomes and other age-related disorders. The aim of the study was to investigate if baseline levels of GDF-15 are associated with total mortality in community living, older adults during eight years of follow-up after simultaneous consideration of key biomarkers and functional parameters.


prospective cohort study including 1,470 community-dwelling older adults aged 65 years or older. GDF-15 was measured by ElectroChemi-Lumisnescence Immunoassays (Roche, Mannheim, Germany). We used Cox-proportional hazards regression to estimate the association of GDF-15 levels with 8-year all-cause mortality.


GDF-15 levels were independently of age and sex strongly associated with many biomarkers such as CRP, IL-6, NT-proBNP, hs-troponines as well as with lipids, metabolic and endocrine markers and kidney function (all P-values < 0.001). GDF-15 showed also a statistically significant correlation to gait speed, hand grip strength and walking duration. In addition, we found a consistent association between levels of GDF-15 and risk of subsequent all-cause mortality which persisted after additional adjustment for key markers of inflammation, cardiac function and damage, and physical function. The hazard ratio (HR) per unit increase of log-transformed GDF-15 was 1.72 (95% CI 1.35; 2.18).


GDF-15 levels were not only strongly associated with many functional parameters and key biomarkers independently of age and sex, but also with 8-year all-cause mortality even after adjusting for gait speed, NT-proBNP and hs-TnT.


biomarkers; cohort study; growth differentiation factor 15; mortality; older people


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