Growth differentiation factor-15 is a predictor of important disease outcomes in patients with COPD

[摘要] Increased levels of growth differentiation factor-15 (GDF15) are associated with cachexia; cardiovascular disease and all-cause mortality. The role of GDF15 in chronic obstructive pulmonary disease (COPD) is unknown.The study included 413 patients with COPD from the Bergen COPD Cohort Study. All patients had a forced expiratory volume in 1xe2x80x85s (FEV1) <80% predicted; a FEV1 to forced vital capacity (FVC) ratio <0.7 and a history of smoking. Spirometry; fat free mass index; blood gases and plasma GDF15 were measured at baseline. Patients were followed for 3xe2x80x85years regarding exacerbations and changes in lung function; and 9xe2x80x85years for mortality. Yearly exacerbation rate; survival and yearly change in FEV1/FVC were evaluated with regression models.Median plasma GDF15 was 0.86xe2x80x85ngxc2xb7mLxe2x88x921 (interquartile range 0.64xe2x80x931.12xe2x80x85ngxc2xb7mLxe2x88x921). The distribution was not normal and GDF15 was analysed as a categorical variable. High levels of GDF15 were associated with a higher exacerbation rate (incidence rate ratio 1.39; 95% CI 1.1xe2x80x931.74; p=0.006; adjusted values). Furthermore; high levels of GDF15 were associated with higher mortality (hazard ratio 2.07; 95% CI 1.4xe2x80x933.1; p<0.001) and an increased decline in both FEV1 (4.29% versus 3.25%) and FVC (2.63% versus 1.44%) in comparison to low levels (p<0.01 for both).In patients with COPD; high levels of GDF15 were independently associated with a higher yearly rate of exacerbations; higher mortality and increased decline in both FEV1 and FVC.

[学科分类] 呼吸医学