The diagnostic value of GDF-15 for myocardial involvement in idiopathic inflammatory myopathy

Abstract

Background Cardiac involvement is a serious complication of idiopathic inflammatory myopathy (IIM). GDF-15 can predict the risk and the prognosis of cardiovascular disease, but its value is unclear in IIM. Objective To investigate the diagnostic value of GDF-15 for myocardial involvement in IIM. Methods A total of 77 IIM patients from May 2018 to August 2020 were included in this retrospective study. Of these, 43 patients underwent cardiac magnetic resonance (CMR) examination. There were 33 SLE patients and 16 healthy people were used as the control group. The concentration of GDF-15 of these groups was measured by ELISA. Results There were significant differences in GDF-15 levels in patients with IIM, SLE and healthy controls (H = 45.291, P<0.001). GDF-15 levels were statistically significant different between IIM patients with the myocardial injury [1484.88(809.07 2835.50) pg/ml] and without myocardial injury [593.26(418.61 784.59) pg/ml, P =0.001]. After adjusted for age, renal function, the risk of myocardial injury in IIM patients increased an average of 0.3% by per increased unit of GDF-15 (odds ratio=1.003, 95% CI: 1.000, 1.007). The level of GDF-15 was positively correlated with extra-cellular volume (ECV) (rs = 0.348, P =0.028). GDF-15 ≥ 929.505 pg/ml (area under the curve=0.856, 95% CI: 0.744, 0.968) predicted myocardial injury in IIM with a sensitivity of 0.75 and specificity of 0.90. Conclusion GDF-15 could serve as a potential biomarker to predict myocardial injury in IIM patients.

Growth differentiation factor-15 serum concentrations reflect disease severity and anemia in patients with inflammatory bowel disease

“…A preliminary report in patients with spondyloarthritis is in line with the data from RA studies, as a pilot study showed a moderate correlation between GDF-15 and multiple indices of spondyloarthritis severity[ 36 ]. Of note, in idiopathic inflammatory myopathy, GDF-15 serum levels correlated with the extent of myocardial injury[ 37 ]. Unfortunately, in previously conducted studies that measured GDF-15 serum levels in IBD patients, an association between disease severity and GDF-15 was not explored.…”

Increased serum concentrations of growth differentiation factor-15 in children with acute rheumatic fever

“…5 The increased levels of growth differentiation factor-15 is reported to be associated with various cardiovascular diseases. [6][7][8][9]15,22 It may provide additional information and act as a predictor in chronic heart failure. 15 It was shown to be a prognostic factor independent of other biomarkers in heart failure with both preserved and reduced ejection fraction, but it is not discriminative or diagnostic for heart failure.…”

“…27 Elevated levels of growth differentiation factor-15 have been reported in patients with myocardial involvement in idiopathic inflammatory myopathy. 7 The elevated levels of growth differentiation factor-15 and correlation of growth differentiation factor-15 levels with erythrocyte sedimentation rate and morning stiffness have been shown in patients with rheumatoid arthritis. 17 Elevated levels of growth differentiation factor-15 have also been reported in patients with myocardial involvement in idiopathic inflammatory myopathy.…”

“…17 Elevated levels of growth differentiation factor-15 have also been reported in patients with myocardial involvement in idiopathic inflammatory myopathy. 7 Li et al 28 reported that children with Kawasaki disease had significantly higher growth differentiation factor-15 levels compared to healthy children, and children with coronary artery involvement had also significantly higher growth differentiation factor-15 levels compared to children with Kawasaki disease without coronary involvement. They also reported a positive correlation between growth differentiation factor-15 and white blood cell count, C-reactive protein, and erythrocyte sedimentation rate.…”

The Emerging Role of Mitochondrial Dysfunction in the Pathogenesis of Idiopathic Inflammatory Myopathies

“… 68 , 109 Similarly, serum levels of growth differentiation factor 15 are increased in both IBM and DM patients. 55 , 110 , 111 Growth differentiation factor 15 has been proposed as a useful marker for oxidative phosphorylation deficiencies, since it has been shown to be increased in patients with mitochondrial defects. 112 Understanding the role of mitokines in health and disease is still an active research area, and much is still unknown regarding the complex mechanisms of interactions between mitokines and cells.…”