Major Adverse Cardiovascular Events and Mortality Prediction by Circulating GDF-15 in Patients with Type 2 Diabetes : A Systematic Review and Meta-Analysis
Xie, Suyi (The Chinese University of Hong Kong)
Li, Qi (The Chinese University of Hong Kong)
Luk, Andrea O. Y. (The Chinese University of Hong Kong)
Lan, Hui-Yao (The Chinese University of Hong Kong)
Chan, Paul K. S. (The Chinese University of Hong Kong)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Chan, Francis K. L. (The Chinese University of Hong Kong)
Fung, Erik (The Chinese University of Hong Kong)
Universitat Autònoma de Barcelona. Departament de Medicina

Data:	2022
Resum:	Background: Growth differentiation factor 15 (GDF-15) is a homeostatic cytokine that regulates neural and cardio-metabolic functions, and its release is increased in response to stress, injury, and inflammation. In patients with coronary artery disease and heart failure (HF), three separate meta-analyses have found that elevated circulating GDF-15 was predictive of major adverse cardiovascular events (MACE), but none has evaluated its effects on incident MACE including HF and mortality hazard in type 2 diabetes. Methods: MEDLINE, EMBASE, and Scopus databases were queried. Articles that met the predefined eligibility criteria, including prospective studies that reported adjusted hazard ratios (aHRs), were selected according to the Cochrane Handbook and PRISMA guidelines. Study endpoints were (1) MACE including HF, and (2) all-cause mortality. Different GDF-15 concentration measurements were harmonized using a validated mathematical approach to express log-transformed values in per standard deviation (SD). Study heterogeneity (I 2), quality, and bias were assessed. Results: 19354 patients in 8 prospective studies were included. In 7 studies that reported 4247 MACE among 19200 participants, the incident rate was 22. 1% during a median follow-up of 5. 6 years. It was found that four of eight studies included HF decompensation or hospitalization as a component of MACE. In 5 studies that reported all-cause mortality, 1893 of 13223 patients died, at an incidence rate of 15. 1% over 5. 0 years. Of note, each 1 SD increase of log[GDF-15] was associated with aHRs of 1. 12 (1. 09-1. 15, I 2 = 5%, p < 0. 000001) and 1. 27 (1. 11-1. 46, I 2 = 86%, p = 0. 00062) and for MACE and all-cause mortality, respectively. Conclusion: Elevated circulating level of GDF-15 was robustly predictive of MACE in patients with T2D but its prognostic significance in the prediction of mortality requires further studies.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Growth differentiation factor 15 ; Adverse cardiovascular outcomes ; Coronary artery disease ; Heart failure ; Type 2 diabetes ; Mortality
Publicat a:	Biomolecules, Vol. 12, Num. 7 (july 2022) , ISSN 2218-273X

DOI: 10.3390/biom12070934
PMID: 35883490

12 p, 1.2 MB

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