title: Increased Serum Level of Growth Differentiation Factor 15 (GDF-15) is Associated with Coronary Artery Disease.
abstract: OBJECTIVE
  There is evidence suggesting that inflammatory responses play a critical role in the development of coronary artery disease (CAD). Growth differentiation factor 15 (GDF-15) is a stress-responsive cytokine. It increases during inflammatory processes and is associated with cardiometabolic risk. However, the relation between GDF-15 and CAD remains largely unknown. Herein, we aimed to evaluate serum GDF-15 levels and predictive values in patients with CAD.
  
  
  METHODS
  Serum levels of GDF-15 in 105 patients with CAD and 96 healthy controls were measured by the enzyme-linked immunosorbent assay. Gensini scores were used to assess severity of CAD. The correlations between the serum GDF-15 levels and Gensini scores were examined using Spearman's correlation. Receivers operating characteristic (ROC) curve analysis was performed to determine the predictive values of GDF-15 levels.
  
  
  RESULTS
  We found that serum GDF-15 levels were significantly increased in CAD group compared with healthy controls group (P < 0.001). Additionally, a positive correlation was observed between GDF-15 and the Gensini score (r = 0.85, P < 0.001). Moreover, the area under the ROC curve assay yielded a satisfactory result of 0.96 (95% confidence interval 0.94-0.98; P < 0.001), and the serum GDF-15 level had a 80.0% sensitivity and 91.7% specificity for predicting CAD.
  
  
  CONCLUSIONS
  These data suggested that increased GDF-15 levels were positively associated with CAD, and GDF-15 might be a useful adjunct in discriminating CAD.
authors.affiliation: Department of Clinical laboratory, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Lei-Lei
authors.initials: LL
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging; D023921:Coronary Stenosis / Q000097:blood* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D055436:Growth Differentiation Factor 15 / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012720:Severity of Illness Index; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15
keywords: Coronary artery disease; Growth differentiation factor 15; ROC curve; Serum