title: Usefulness of growth differentiation factor-15 levels to predict diabetic cardiomyopathy in asymptomatic patients with type 2 diabetes mellitus.
abstract: Growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine that increased in patients with established type 2 diabetes mellitus (DM). Diabetic cardiomyopathy (DC), defined as left ventricular diastolic dysfunction (LVDD) in patients with type 2 DM in the absence of arterial hypertension, heart disease, or other heart disease, was assessed by GDF-15 levels in type 2 DM patients with and without DC. A total of 213 DM outpatients had blood samples drawn and on the same day (basal) underwent echocardiography and treadmill exercise testing. Plasma GDF-15 concentrations were measured by an enzyme-linked immunosorbent assay (ELISA) at baseline. DC was diagnosed in the presence of LVDD, defined when early mitral valve flow velocity (E) and early diastolic lengthening velocity (E') ratio was E/E' ≥ 15. The prevalence of DC was 21.13%. GDF-15 levels were higher in patients with DC compared with those without DC (5,273 [8,708.4] vs 2,812.66 [7,662.1] pg/ml, respectively, p <0.001). We assessed predictors of DC using multivariate regression analysis. GDF-15 (odds ratio 9.9; 95% confidence interval [3.9 to 24.5], p <0.001) was the unique independent predictor of DC. The results of receiver operating characteristic curve show that the cut-off point of 3,812 pg/ml of GDF-15 was indicative for DC (AUC = 0.83, sensitivity = 82.2% and specificity = 70.2%, p <0.0001). In conclusion, GDF-15 represents a useful and novel tool to screen DC in patients with type 2 DM.
authors: Department of Cardiology, Hospital Universitario de Canarias, Tenerife, Spain; Instituto Universitario de Tecnología Biomédicas, Tenerife, Spain. Electronic address: adrvdg@hotmail.com.
authors: Alberto
authors: A
authors: Dominguez-Rodriguez
authors: Instituto Universitario de Tecnología Biomédicas, Tenerife, Spain; Department of Physiology, University of La Laguna, Tenerife, Spain.
authors: Pedro
authors: P
authors: Abreu-Gonzalez
authors: Department of Cardiology, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors: Pablo
authors: P
authors: Avanzas
mesh_terms: D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D058065:Diabetic Cardiomyopathies / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D004452:Echocardiography; D004797:Enzyme-Linked Immunosorbent Assay; D005080:Exercise Test; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D015995:Prevalence; D011379:Prognosis; D012372:ROC Curve; D013030:Spain / Q000453:epidemiology; D013318:Stroke Volume
chemical_list: D015415:Biomarkers; D055436:Growth Differentiation Factor 15