Increased serum levels of GDF-15 associated with mortality and subclinical atherosclerosis in patients on maintenance hemodialysis
Küçük Resim Yok
Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Urban & Vogel
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background/aims. Increased carotid intima-media thickness (CIMT) was shown to be an independent predictor of cardiovascular (CV) mortality in dialysis patients and the general population. Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor superfamily, is produced by cardiomyocytes and atherosclerotic lesions under stress conditions such as inflammation. We assessed associations between serum concentrations of GDF-15, mortality, and CIMT for subclinical atherosclerosis in hemodialysis (HD) patients. Methods. A total of 87 patients on maintenance hemodialysis and 45 sex-and age-matched healthy controls were included in this prospective study. Serum GDF-15 levels were measured by ELISA. CIMT was assessed by Doppler ultrasonography. The association between serum GDF-15 levels and mortality was assessed using Cox regression analysis with serum levels categorized into two groups according to the median value (328.18 pg/ml). Patients were followed for 2 years and cause-specific and all-cause mortality were determined. Results. The median level of serum GDF-15 was significantly higher in HD patients than controls [ 328 (198-522) vs. 176 (101-289) pg/ml, p<0.01, respectively]. Serum GDF-15 levels were correlated to CIMT (r=0.607, p<0.001), C-reactive protein (CRP; r=0.250, p=0.010), HD duration (r=0.376, p=0.004), and serum albumin (r=-0.156, p=0.030). The multivariate analysis revealed that GDF-15 was found to be an independent variable of CIMT in HD patients. In the study, the serum GDF-15 level was an independent marker of all-cause of mortality when adjusted for age, CRP, and history of diabetes mellitus. Conclusion. The relationship between serum GDF-15, mortality, and carotid artery thickening suggests that GDF-15 may be a novel marker of atherosclerosis, inflammation, and malnutrition in HD patients.
Açıklama
Anahtar Kelimeler
Growth differentiation factor 15; Atherosclerosis; Renal dialysis; Mortality; End-stage kidney disease
Kaynak
Herz
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
40
