Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research Institute, Kyung Hee University, Seoul, Korea.
Division of Geriatric Medicine and Gerontology, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
J Gerontol A Biol Sci Med Sci. 2022 Apr 1;77(4):770-780. doi: 10.1093/gerona/glab201.
Growth differentiation factor 15 (GDF-15) is associated with disease progression, mitochondrial dysfunction, and mortality. Elevated GDF-15 level was recently reported to be associated with poorer physical performance in healthy adults. However, the association between serum GDF-15 level and sarcopenia in community-dwelling older adults has not been well characterized.
We conducted cross-sectional (n = 929) and 2-year prospective analyses (n = 788) among participants aged 70-84 years enrolled in the Korean Frailty and Aging Cohort Study. Participants with an estimated glomerular filtration rate of <60 mL/min/1.73 m2 were excluded. Appendicular lean mass was measured using dual-energy x-ray absorptiometry. Sarcopenia status was determined according to the Asian Working Group for Sarcopenia-2019 algorithm.
At baseline, 16.6% of the participants had sarcopenia. Median GDF-15 concentration was higher in the sarcopenic group than in the non-sarcopenic group (1221 pg/mL vs 1019 pg/mL, p < .001). In the multivariate analysis adjusted for cardiometabolic risk and biological factors, the highest GDF-15 tertile (≥1245 pg/mL) had an increased likelihood of sarcopenia (odds ratio, 1.96; 95% confidence interval, 1.16-3.33) than the lowest tertile (<885 pg/mL). During the 2-year follow-up period, 67 (10.1%) individuals without sarcopenia at baseline developed sarcopenia. There were no significant associations between baseline serum GDF-15 levels and incident sarcopenia or its components (all p > .05).
Elevated GDF-15 was associated with prevalent sarcopenia but not able to predict incident sarcopenia in the 2-year follow-up. Further studies are needed to explore the pathophysiological roles of GDF-15 in the development of sarcopenia.
生长分化因子 15(GDF-15)与疾病进展、线粒体功能障碍和死亡率有关。最近有报道称,高水平的 GDF-15 与健康成年人较差的身体表现有关。然而,血清 GDF-15 水平与社区居住的老年人大腿肌减少症之间的关系尚未得到很好的描述。
我们对参加韩国衰弱和衰老队列研究的 70-84 岁参与者进行了横断面(n=929)和 2 年前瞻性分析(n=788)。排除估计肾小球滤过率<60 mL/min/1.73 m2 的参与者。使用双能 X 射线吸收法测量四肢瘦体重。根据亚洲肌少症工作组 2019 算法确定肌少症状态。
基线时,16.6%的参与者患有肌少症。肌少症组的 GDF-15 浓度中位数高于非肌少症组(1221 pg/mL 比 1019 pg/mL,p<.001)。在调整了心血管代谢风险和生物学因素的多变量分析中,最高 GDF-15 三分位组(≥1245 pg/mL)发生肌少症的可能性高于最低三分位组(<885 pg/mL)(比值比,1.96;95%置信区间,1.16-3.33)。在 2 年的随访期间,67 名(10.1%)基线时无肌少症的个体在随访期间发展为肌少症。基线时血清 GDF-15 水平与肌少症或其成分的发生均无显著相关性(均 p>.05)。
升高的 GDF-15 与现患肌少症相关,但不能预测 2 年随访期间的肌少症发生。需要进一步研究来探索 GDF-15 在肌少症发展中的病理生理作用。