Center for Kidney Disease, 2nd Affiliated Hospital, Nanjing Medical University, Nanjing, China.
Department of Radiology, University of Washington, Seattle, WA, USA.
Ren Fail. 2021 Dec;43(1):340-346. doi: 10.1080/0886022X.2021.1880938.
Growth differentiation factor 15(GDF15) is a distant member of the superfamily of the transforming growth factor beta (TGF-β). It has been established that increased GDF15 levels are associated with an increased risk of cardiovascular disease. However, the detail effect of GDF15 on cardiovascular system in patients with chronic kidney disease (CKD) needs detail analysis.
Patients with CKD who did not need dialysis were enrolled in the study. Blood pressure (BP), endothelial function, pulse wave velocity (PWV) and heart rate variability (HRV) were taken in all subjects. Plasma GDF15 concentration was measured by an enzyme-linked immunosorbent assay.
Among the 355 participants, the mean age was 57.4 (±14.2) years old and the mean estimated glomerular filtration rate (eGFR) was 50.1 (±33.2) mL/min/1.73m. The average plasma GDF15 level was 1394.7 (±610.1) pg/mL. Higher GDF15 concentrations were significantly associated with decreased eGFR and increased urine protein-to-creatinine ratio (uPCR). In multivariable models, after adjusting for potential confounders, plasma GDF15 has negative concerning with HRV parameters including the standard deviation of the normal-to-normal (NN) interval (SDNN), the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD) and Triangular Index.
We observed there was a link between increased plasma of GDF15 and decreased HRV. The mechanisms and prediction of GDF15 in the cardiovascular disease with CKD needs further discussion and study.
生长分化因子 15（GDF15）是转化生长因子β（TGF-β）超家族的一个远亲。已经证实，GDF15 水平的升高与心血管疾病风险的增加有关。然而，GDF15 对慢性肾脏病（CKD）患者心血管系统的详细影响需要详细分析。
本研究纳入了不需要透析的 CKD 患者。所有患者均测量血压（BP）、内皮功能、脉搏波速度（PWV）和心率变异性（HRV）。通过酶联免疫吸附试验测量血浆 GDF15 浓度。
在 355 名参与者中，平均年龄为 57.4（±14.2）岁，平均估算肾小球滤过率（eGFR）为 50.1（±33.2）mL/min/1.73m。平均血浆 GDF15 水平为 1394.7（±610.1）pg/mL。较高的 GDF15 浓度与较低的 eGFR 和较高的尿蛋白/肌酐比值（uPCR）显著相关。在多变量模型中，在调整了潜在混杂因素后，血浆 GDF15 与 HRV 参数呈负相关，包括正常-正常（NN）间期的标准差（SDNN）、NN 间期差值均方根（RMSSD）和三角指数。
我们观察到血浆 GDF15 升高与 HRV 降低之间存在关联。GDF15 在 CKD 心血管疾病中的机制和预测需要进一步讨论和研究。
