Diabetes Metab J.  2014 Dec;38(6):472-479. 10.4093/dmj.2014.38.6.472.

GDF15 Is a Novel Biomarker for Impaired Fasting Glucose

• Hong JH
• Chung HK
• Park HY
• Joung KH
• Lee JH
• Jung JG
• Kim KS
• Kim HJ
• Ku BJ
• Shong M

• KMID: 2174085
• DOI: http://doi.org/10.4093/dmj.2014.38.6.472

Abstract

BACKGROUND
Growth differentiation factor-15 (GDF15) is a protein that belongs to the transforming growth factor beta superfamily. An elevated serum level of GDF15 was found to be associated with type 2 diabetes mellitus (T2DM). T2DM is an inflammatory disease that progresses from normal glucose tolerance (NGT) to impaired fasting glucose (IFG). Hence, we aimed to validate the relationship between GDF15 and IFG.
METHODS
The participants were divided into the following three groups: NGT (n=137), IFG (n=29), and T2DM (n=75). The controls and T2DM outpatients visited the hospital for routine health check-ups. We used fasting blood glucose to detect IFG in nondiabetic patients. We checked the body mass index (BMI), C-reactive protein level, metabolic parameters, and fasting serum GDF15 level.
RESULTS
Age, BMI, triglyceride, insulin, glucose, homeostatic model assessment-insulin resistance (HOMA-IR), and GDF15 levels were elevated in the IFG and T2DM groups compared to the NGT group. In the correlation analysis between metabolic parameters and GDF15, age and HOMA-IR had a significant positive correlation with GDF15 levels. GDF15 significantly discriminated between IFG and NGT, independent of age, BMI, and HOMA-IR. The serum levels of GDF15 were more elevated in men than in women. As a biomarker for IFG based on the receiver operating characteristic curve analysis, the cutoff value of GDF15 was 510 pg/mL in males and 400 pg/mL in females.
CONCLUSION
GDF15 had a positive correlation with IR independent of age and BMI, and the serum level of GDF15 was increased in the IFG and T2DM groups. GDF15 may be a novel biomarker for detecting IFG in nondiabetic patients.

Keyword

Biological markers; Diabetes mellitus, type 2; Growth differentiation factor 15; Prediabetic state

MeSH Terms

Biomarkers
Blood Glucose
Body Mass Index
C-Reactive Protein
Diabetes Mellitus, Type 2
Fasting*
Female
Glucose*
Growth Differentiation Factor 15
Humans
Insulin
Male
Outpatients
Prediabetic State
ROC Curve
Transforming Growth Factor beta
Triglycerides
Blood Glucose
C-Reactive Protein
Glucose
Growth Differentiation Factor 15
Insulin
Transforming Growth Factor beta

Figure

• 

  Fig. 1 The differences in growth differentiation factor-15 (GDF15) levels among the normal glucose tolerance (NGT), impaired fasting glucose (IFG), and type 2 diabetes mellitus (T2DM) groups. aP<0.001.

• 

  Fig. 2 Prediction of impaired fasting glucose (IFG) based on the receiver operating characteristic (ROC) curve of growth differentiation factor-15 (A, total; B, male; C, female).

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