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Growth differentiation factor-15 and metabolic features in chronic heart failure: Insights from the SUPPORT Trial -GDF15 across the BMI spectrum.
Teramoto, Kanako; Nochioka, Kotaro; Sakata, Yasuhiko; Kato, Eri Toda; Nishimura, Kunihiro; Shimokawa, Hiroaki; Yasuda, Satoshi.
Afiliación
  • Teramoto K; Department of Biostatistics, National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Nochioka K; Division of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: nochioka@cardio.med.tohoku.ac.jp.
  • Sakata Y; Department of Clinical Medicine and Development, National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Kato ET; Department of Cardiovascular Medicine and Department of Clinical Laboratory, Kyoto University Hospital, Kyoto, Japan.
  • Nishimura K; Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Japan.
  • Shimokawa H; Division of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; International University of Health and Welfare Graduate School, Narita, Japan.
  • Yasuda S; Division of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
Int J Cardiol ; 407: 132093, 2024 Jul 15.
Article en En | MEDLINE | ID: mdl-38663803
ABSTRACT

BACKGROUND:

GDF15 plays pivotal metabolic roles in nutritional stress and serves as a physiological regulator of energy balance. However, the patterns of GDF15 levels in underweight or obese patients with chronic heart failure (CHF) are not well-understood.

METHODS:

We assessed serum GDF15 levels at baseline and 3 years and the temporal changes in 940 Japanese patients (642 paired samples), as a sub-analysis of the SUPPORT trial (age 65.9 ± 10.1 years). The GDF15 levels were analyzed across BMI groups (underweight [<18.5 kg/m2; n = 50], healthy weight [18.5-22.9; n = 27 5], overweight [23-24.9; n = 234], and obese [≥25; n = 381]), following WHO recommendations for the Asian-Pacific population. Landmark analysis at 3 years assessed the association between GDF15 levels and HF hospitalization or all-cause death.

RESULTS:

Compared to the healthy weight group, the underweight group included more females (54.0%) with advanced HF (NYHA class III; 20.0%) and exhibited increased GDF15 level (1764 pg/mL [IQR 1067-2633]). Obese patients, younger (64.2 years) and diabetic (53%), had a similar GDF15 level to the healthy weight group. A higher baseline GDF15 level was associated with worse outcomes across the BMI spectrum. GDF15 increased by 208 [21-596] pg/mL over 3 years, with the most substantial increase observed in the underweight group (by +28.9% [6.2-81.0]). Persistently high GDF15 levels (≥1800 pg/mL) was independently associated with worse outcomes after 3 years (adjusted HR 1.8 [95%CI 1.1-2.9]).

CONCLUSIONS:

In underweight patients with CHF, GDF15 level was elevated at baseline and experienced the most significant increase over 3 years. Its consistent elevation suggested a worse outcome.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Masa Corporal / Factor 15 de Diferenciación de Crecimiento / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Índice de Masa Corporal / Factor 15 de Diferenciación de Crecimiento / Insuficiencia Cardíaca Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Países Bajos