title: Clinical significance of serum growth differentiation factor-15 levels in systemic sclerosis: association with disease severity.
abstract: OBJECTIVE
  To determine serum growth differentiation factor-15 (GDF-15) levels and their clinical associations in patients with systemic sclerosis (SSc).
  
  
  METHODS
  Serum GDF-15 levels were examined by enzyme-linked immunosorbent assay in 61 patients with SSc and 24 healthy individuals. In a retrospective longitudinal study, sera from 14 patients with SSc were analyzed (duration of follow-up 1.2-7.2 years).
  
  
  RESULTS
  Serum GDF-15 levels were significantly elevated in SSc patients (1340 ± 910 pg/ml) compared with healthy individuals (213 ± 79 pg/ml; P < 0.001). Among SSc patients, patients with diffuse cutaneous SSc (n = 31) had higher levels of serum GDF-15 (1609 ± 1069 pg/ml) than those with limited cutaneous SSc (n = 30; 1142 ± 646 pg/ml; P < 0.05). SSc patients with high GDF-15 levels (≥1000 pg/ml) had pulmonary fibrosis, decreased vital capacity, and decreased diffusion capacity for carbon monoxide more often than those with low GDF-15 levels (<1000 pg/ml). GDF-15 levels correlated positively with the extent of skin sclerosis and inversely with percentage vital capacity and diffusion capacity for carbon monoxide in patients with SSc. In a longitudinal study, serum GDF-15 levels were generally decreased during the follow-up.
  
  
  CONCLUSIONS
  Serum GDF-15 levels were increased in patients with SSc and associated with the extent of skin sclerosis and the severity of pulmonary fibrosis. These results suggest that GDF-15 may play a role in the development of cutaneous and pulmonary fibrosis in SSc. Measurement of serum GDF-15 may be useful for risk stratification in early disease stage.
authors.affiliation: Department of Dermatology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yanabak-der@h.u-tokyo.ac.jp
authors.forename: Koichi
authors.initials: K
authors.lastname: Yanaba
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Asano
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Tada
authors.forename: Makoto
authors.initials: M
authors.lastname: Sugaya
authors.forename: Takafumi
authors.initials: T
authors.lastname: Kadono
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sato
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002248:Carbon Monoxide / Q000378:metabolism; D002648:Child; D018450:Disease Progression; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity / Q000502:physiology; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D045743:Scleroderma, Diffuse / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D012594:Scleroderma, Localized / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology; D055815:Young Adult
chemical_list: D055436:Growth Differentiation Factor 15; D002248:Carbon Monoxide