title: GDF15 Is a Novel Biomarker for Impaired Fasting Glucose.
abstract: BACKGROUND
  Growth differentiation factor-15 (GDF15) is a protein that belongs to the transforming growth factor β 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea. ; Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Jun Hwa
authors.initials: JH
authors.lastname: Hong
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Hyo Kyun
authors.initials: HK
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
authors.forename: Hye Yoon
authors.initials: HY
authors.lastname: Park
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea. ; Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Kyong-Hye
authors.initials: KH
authors.lastname: Joung
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea. ; Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Ju Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Jin Gyu
authors.initials: JG
authors.lastname: Jung
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea. ; Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Koon Soon
authors.initials: KS
authors.lastname: Kim
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea. ; Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea. ; Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Bon Jeong
authors.initials: BJ
authors.lastname: Ku
authors.affiliation: Research Center for Endocrine and Metabolic Diseases, Chungnam National University Hospital, Daejeon, Korea. ; Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Minho
authors.initials: M
authors.lastname: Shong
keywords: Biological markers; Diabetes mellitus, type 2; Growth differentiation factor 15; Prediabetic state