Growth differentiation factor-15 is a predictor of important disease outcomes in patients with COPD. Issue 3 (16th March 2017)

• Record Type: Journal Article
• Authors: Husebø, Gunnar R.; Grønseth, Rune; Lerner, Lorena; Gyuris, Jeno; Hardie, Jon A.; Bakke, Per S.; Eagan, Tomas M.
• Is Part Of: European respiratory journal. Volume 49:Issue 3(2017)
• Publication Date: 2017-03-16
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; 616.2
• DOI: 10.1183/13993003.01298-2016
• Languages: English
• ISSNs: 0903-1936

Abstract

Increased levels of growth differentiation factor-15 (GDF15) are associated with cachexia, cardiovascular disease and all-cause mortality. The role of GDF15 in chronic obstructive pulmonary disease (COPD) is unknown. The study included 413 patients with COPD from the Bergen COPD Cohort Study. All patients had a forced expiratory volume in 1 s (FEV1 ) <80% predicted, a FEV1 to forced vital capacity (FVC) ratio <0.7 and a history of smoking. Spirometry, fat free mass index, blood gases and plasma GDF15 were measured at baseline. Patients were followed for 3 years regarding exacerbations and changes in lung function, and 9 years for mortality. Yearly exacerbation rate, survival and yearly change in FEV1 /FVC were evaluated with regression models. Median plasma GDF15 was 0.86 ng·mL −1 (interquartile range 0.64–1.12 ng·mL −1 ). The distribution was not normal and GDF15 was analysed as a categorical variable. High levels of GDF15 were associated with a higher exacerbation rate (incidence rate ratio 1.39, 95% CI 1.1–1.74, p=0.006, adjusted values). Furthermore, high levels of GDF15 were associated with higher mortality (hazard ratio 2.07, 95% CI 1.4–3.1, p<0.001) and an increased decline in both FEV1 (4.29% versus 3.25%) and FVC (2.63% versus 1.44%) in comparison to low levels (p<0.01 for both). In patients with COPD, high levels of GDF15 were independently associated with a higher yearly rate of exacerbations, higher mortality and increased decline in both FEV1 and FVC. In COPD, GDF15 predicts a higher mortality, increased COPD exacerbation rate and a faster decline in FEV 1 and FVC http://ow.ly/yDgn307n0SO