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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.

Author information

1
Institute of Epidemiology and Medical Biometry, Ulm University, D-89081 Ulm, Germany.
2
Agaplesion Bethesda Hospital, Geriatric Research Unit, Ulm University and Geriatric Center Ulm/Alb-Donau, 89073 Ulm, Germany.
3
Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, 89081 Ulm, Germany.
4
Deutsches Herzzentrum München, Technische Universität München, 80636 Munich, Germany.
5
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Technische Universität München, 80636 Munich, Germany.
6
Department of Geriatrics and Geriatric Rehabilitation, Robert-Bosch-Hospital, 70376 Stuttgart, Germany.
7
IB Hochschule Berlin, Studienzentrum Stuttgart, 70178 Stuttgart, Germany.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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).

CONCLUSIONS:

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.

KEYWORDS:

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

PMID:
30855645
DOI:
10.1093/ageing/afz022

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