Wu Yulang, Wei Yude, He Jinrong, Zhou Fengkun
The Second Department of Neurology, The First People's Hospital of Nanning, No. 90, Qixing Road, Nanning, Guangxi Province, 530022, China.
Head Face Med. 2024 Dec 28;20(1):72. doi: 10.1186/s13005-024-00476-4.
Growth-differentiation factor 15 (GDF-15) is a cytokine involved in cellular stress responses and inflammation. This meta-analysis evaluates the association between circulating GDF-15 levels and functional outcomes in patients with acute ischemic stroke (AIS). A comprehensive search of Medline, Web of Science, Embase, Wanfang, and CNKI was conducted up to July 15, 2024. Observational studies with longitudinal follow-up that measured GDF-15 levels within 24 h of stroke onset and reported functional outcomes, defined as a modified Rankin Scale (mRS) score of ≥ 2, were included. Odds ratios (OR) with 95% confidence intervals (CI) were used to quantify associations. Heterogeneity was evaluated using I² statistics, and a random-effects model was used to pool the results by incorporating the influence of heterogeneity. Ten studies involving 4,231 patients were included. The pooled OR indicated that high circulating GDF-15 levels were associated with a significantly higher risk of poor functional outcomes at 3 months (OR: 2.60, 95% CI: 1.95 to 3.46, p < 0.001). Sensitivity analyses by excluding one study at a time did not significantly change the results. Subgroup analyses revealed stronger associations in studies with GDF-15 cutoff values < 1200 ng/L as compared to ≥ 1200 ng/L, and in those defining poor outcomes as mRS ≥ 3 as compared to those ≥ 2. In conclusion, elevated circulating GDF-15 levels are associated with worse functional outcomes following AIS. These findings support the potential use of GDF-15 as a prognostic biomarker in stroke patients. Further research is warranted to confirm these results and explore clinical applications.
生长分化因子15（GDF - 15）是一种参与细胞应激反应和炎症的细胞因子。本荟萃分析评估了急性缺血性卒中（AIS）患者循环GDF - 15水平与功能结局之间的关联。截至2024年7月15日，对Medline、科学网、Embase、万方和中国知网进行了全面检索。纳入了纵向随访的观察性研究，这些研究在卒中发作后24小时内测量了GDF - 15水平，并报告了功能结局，功能结局定义为改良Rankin量表（mRS）评分≥2。采用95%置信区间（CI）的优势比（OR）来量化关联。使用I²统计量评估异质性，并采用随机效应模型通过纳入异质性影响来汇总结果。纳入了10项涉及4231例患者的研究。汇总的OR表明，循环GDF - 15水平升高与3个月时功能结局不良的风险显著更高相关（OR：2.60，95% CI：1.95至3.46，p < 0.001）。每次排除一项研究的敏感性分析并未显著改变结果。亚组分析显示，与GDF - 15临界值≥1200 ng/L的研究相比，GDF - 15临界值<1200 ng/L的研究中关联更强；与将不良结局定义为mRS≥2的研究相比，将不良结局定义为mRS≥3的研究中关联更强。总之，循环GDF - 15水平升高与AIS后更差的功能结局相关。这些发现支持将GDF - 15作为卒中患者预后生物标志物的潜在用途。有必要进行进一步研究以证实这些结果并探索临床应用。
