Relationship between hepcidin and GDF15 in anemic patients with type 2 diabetes without overt renal impairment

Hong, Jun Hwa; Choi, Young Yeon; Min, Byong-Keol; Park, Kang Seo; Seong, Kayeon; Lee, In Kyu; Kim, Jung Guk

doi:10.1016/j.diabres.2015.05.001

Cited by 21 publications

(14 citation statements)

References 38 publications

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“…GDF-15 levels were also found to be elevated in patients with T2DM compared to healthy subjects [19]. Hong et al reported higher GDF-15 levels in anemic patients with T2DM compared to those without anemia [23]. As the anemia may cause conflicting results also in impaired glucose tolerance group, we included only nonanemic subjects and found elevated GDF-15 levels in patients with impaired glucose tolerance.…”

Section: Discussionmentioning

confidence: 99%

“…But some recent studies showed a bidirectional association between GDF-15 and hepcidin which was described as a positive correlation in elevated GDF-15 levels but a negative association in extremely elevated GDF-15 levels [31]. A positive correlation between GDF-15 and hepcidin levels was also reported in patients with T2DM including anemic subjects [23]. Our study demonstrated a significant positive relationship between GDF-15 and hepcidin levels suggesting persistent relationship between GDF-15 and hepcidin, even in nonanemic subjects.…”

Section: Discussionmentioning

confidence: 99%

“…A strong positive relationship between hepcidin and GDF-15 has been found in anemic patients with T2DM [23]. It has been suggested that anemia may have an effect on the hepcidin and GDF-15 levels [24], but no data is available regarding the hepcidin and GDF-15 levels and their possible relationships in nonanemic subjects with prediabetes.…”

Section: Introductionmentioning

confidence: 99%

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GDF-15 and Hepcidin Levels in Nonanemic Patients with Impaired Glucose Tolerance

Yalcin

Altınova

Aktürk

et al. 2016

Journal of Diabetes Research

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Aims. Growth Differentiation Factor-15 (GDF-15) has been suggested as one of the regulators of hepcidin, an important regulatory peptide for iron deposition. Current data is conflicting about the relationship between hepcidin and disorders of glucose metabolism. We aimed to investigate serum hepcidin and GDF-15 concentrations and their associations with each other, in nonanemic subjects with impaired glucose tolerance (IGT) in comparison with the nonanemic subjects with normal glucose tolerance (NGT). Methods. Thirty-seven subjects with IGT and 32 control subjects with NGT, who were age-, gender-, and body mass index- (BMI-) matched, were included in the study. Results. Serum GDF-15 levels were significantly higher in IGT compared to NGT. There were no differences in hepcidin, interleukin-6, and high sensitive C-reactive protein levels between the groups. We found a positive correlation between GDF-15 and hepcidin levels. There were also positive correlations between GDF-15 and age, uric acid, creatinine, and area under the curve for glucose (AUC-G). Hepcidin was correlated positively with ferritin levels. In the multiple regression analysis, GDF-15 concentrations were independently associated with age, uric acid, and AUC-G. Conclusions. Impaired glucose tolerance is associated with increased GDF-15 levels even in the absence of anemia, but the levels of hepcidin are not significantly altered in prediabetic state.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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GDF-15 and Hepcidin Levels in Nonanemic Patients with Impaired Glucose Tolerance

Yalcin

Altınova

Aktürk

et al. 2016

Journal of Diabetes Research

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“…An association between anemia and GDF-15 has also been documented in previous studies. Hong et al [21] determined that anemia in type 2 DM without overt renal dysfunction was independently associated with increasing hepcidin and GDF-15 levels. Another study revealed an association among GDF-15, anemia, and inflammation in elderly patients with early CKD [22].…”

Section: Discussionmentioning

confidence: 99%

Association between Plasma Levels of Growth Differentiation Factor-15 and Renal Function in the Elderly: Korean Frailty and Aging Cohort Study

Kim

Won

et al. 2019

Kidney Blood Press Res

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Background/Aims: Growth differentiation factor-15 (GDF-15) expression has been reported to increase in response to tissue damage and has recently emerged as a useful biomarker for various diseases. Although emerging evidence supports the clinicopathological value of GDF-15 in renal impairment, few studies have analyzed it in the elderly. Thus, we conducted a cross-sectional study to investigate the association of plasma GDF-15 with renal function and the presence of chronic kidney disease (CKD) in community-dwelling elderly. Materials: The present study was based on the baseline data of the Korean Frailty and Aging Cohort Study (KFACS), a nationwide cohort study that began in 2016. Of the 1,559 participants assessed in the first year, 443 with available plasma GDF-15 data were enrolled in this study. We investigated the association of plasma GDF-15 levels with clinical and biochemical parameters. The study population was divided into two groups according to renal function (CKD and non-CKD groups) to investigate whether GDF-15 can determine the presence of renal dysfunction in the elderly. Plasma GDF-15 was measured by enzyme-linked immunosorbent assay (ELISA) kit. Results: In a simple regression analysis, the levels of plasma GDF-15 were negatively correlated with estimated glomerular filtration rate (eGFR; r = –0.383, p < 0.001). In multiple linear regression analysis, GDF-15 levels were still significantly correlated with eGFR, even after adjusting for other parameters (r = –0.259, p < 0.001). Plasma GDF-15 levels were significantly higher in the elderly with CKD than in those without CKD (2,364.025 ± 1,052.23 ng/L and 1,451.23 ± 835.79 ng/L, respectively; p < 0.001). The optimal cut-off value of plasma GDF-15 for detecting the presence of CKD was 1,699.4 ng/L (76.5% sensitivity and 76.0% specificity), as determined by the receiver operating characteristic curve. The area under the curve was 0.793 ± 0.033 (95% CI 0.729–0.857, p < 0.001). Conclusion: Plasma GDF-15 levels were negatively associated with eGFR and were significantly increased in the elderly with CKD. Our results suggested that plasma GDF-15 might be a useful marker for discriminating renal impairment in the elderly. Further large and prospective outcome studies of extended duration are needed.

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“…Anemia is a common condition in pts with diabetes that is associated with disease progression, development of comorbidities, and impaired quality of life [37]. Increased levels of C-reactive protein (CRP) were found in anemic diabetic pts compared to non-anemic diabetics independently of renal function (Figure 1) [38].In pts with diabetic renal disease, anemia is often more severe and occurs at an earlier stage than in nondiabetics. Furthermore, anemia was found to be an independent predictor of mortality in pts with diabetic nephropathy [39,40].…”

Section: Diabetes and Padmentioning

confidence: 99%

Diabetes, renal dysfunction, inflammation, and anemia: the deadly quartet in peripheral artery disease

Vrsalović¹,

Vučur²

2016

Endocr oncol metab

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The article reviews the burden of peripheral artery disease (PAD) and its association with diabetes, renal dysfunction, inflammation, and anemia. PAD is a marker of advanced atherosclerotic disease and is associated with a poor quality of life, ischemic events, and mortality. Polyvascular involvement is often observed in PAD patients (pts), and contributes to the greater risk of all-cause and cardiovascular mortality. Diabetes is a major risk factor for PAD, and the presence of PAD in diabetic pts is associated with unfavorable cardiovascular outcomes. In comparison to nondiabetic PAD pts, diabetic pts often have severe forms of PAD such as foot ulcers and gangrene, and more often have involvement of the distal extremities. Diabetes is often accompanied by anemia, particularly in the presence of impaired renal function. Chronic kidney disease and PAD share some common risk factors and frequently coexist. In PAD pts, renal dysfunction has been associated with an increased risk of major adverse cardiovascular events and mortality. Anemia is quite prevalent in PAD pts, especially in those with critical limb ischemia. The severity of anemia has been identified as an independent predictor of limb loss and mortality. C-reactive protein (CRP) is associated with the development of PAD and diabetes. Increased levels of CRP in diabetic pts intensify the risk for PAD development. Data regarding the prognostic role of CRP in PAD pts suggest that CRP is a better prognostic marker for short-term rather than long-term mortality. Considering the close relationship between diabetes, renal dysfunction, inflammation, and anemia in PAD pts, a multidisciplinary approach is needed in order to improve quality of life and prevent ischemic events and fatal outcomes.

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Relationship between hepcidin and GDF15 in anemic patients with type 2 diabetes without overt renal impairment

Cited by 21 publications

References 38 publications

GDF-15 and Hepcidin Levels in Nonanemic Patients with Impaired Glucose Tolerance

GDF-15 and Hepcidin Levels in Nonanemic Patients with Impaired Glucose Tolerance

Association between Plasma Levels of Growth Differentiation Factor-15 and Renal Function in the Elderly: Korean Frailty and Aging Cohort Study

Diabetes, renal dysfunction, inflammation, and anemia: the deadly quartet in peripheral artery disease

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