Liu Xu, Essien Anko E, Lu Wenhao, Jin Hongfu, Pan Linyuan, Li Yusheng, Xiao Wenfeng
Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, China.
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
Bone Joint Res. 2025 May 6;14(5):389-397. doi: 10.1302/2046-3758.145.BJR-2024-0230.R2.
This systematic review aimed to investigate the association between growth differentiation factor 15 (GDF-15) and rheumatoid arthritis (RA) disease activity, explore the differences at the genetic level, and evaluate the value of GDF-15 in diagnosing RA.
A comprehensive literature search was conducted using PubMed, Web of Science, Cochrane Library, and Embase on 23 August 2023. Methodological quality was independently assessed by using the Agency for Healthcare Research and Quality scale. The primary parameters analyzed were the serum GDF-15 concentration, disease activity, and diagnostic sensitivity and specificity.
A total of 469 documents were retrieved, and five clinical studies were ultimately included. In the included studies, GDF-15 serum levels were found to be notably greater in RA patients than in healthy individuals, and these levels exhibited a positive correlation with disease severity. Furthermore, increased GDF-15 serum levels were associated with specific gene variations in RA patients, but varied according to ethnicity. In two included studies, GDF-15 showed high diagnostic sensitivity and specificity for highly active RA, demonstrating its utility as a diagnostic biomarker of RA.
GDF-15 expression is increased in RA patients and is associated with disease activity; thus, GDF-15 is potentially an effective diagnostic biomarker for RA. However, additional high-quality studies, especially randomized controlled trials and cohort studies with follow-up data, are needed to assess the role of GDF-15 in RA.
本系统评价旨在研究生长分化因子15(GDF - 15)与类风湿关节炎(RA)疾病活动度之间的关联,探索基因水平的差异,并评估GDF - 15在RA诊断中的价值。
于2023年8月23日使用PubMed、Web of Science、Cochrane图书馆和Embase进行全面的文献检索。采用医疗保健研究与质量机构量表独立评估方法学质量。分析的主要参数为血清GDF - 15浓度、疾病活动度以及诊断敏感性和特异性。
共检索到469篇文献,最终纳入5项临床研究。在纳入的研究中,发现RA患者的GDF - 15血清水平显著高于健康个体,且这些水平与疾病严重程度呈正相关。此外,RA患者血清GDF - 15水平升高与特定基因变异有关,但因种族而异。在两项纳入研究中,GDF - 15对高度活跃的RA显示出高诊断敏感性和特异性,证明其作为RA诊断生物标志物的效用。
RA患者中GDF - 15表达增加且与疾病活动度相关;因此,GDF - 15可能是RA的一种有效诊断生物标志物。然而,需要更多高质量研究,尤其是随机对照试验和有随访数据的队列研究,以评估GDF - 15在RA中的作用。