Growth differentiation factor-15 and metabolic features in chronic heart failure: Insights from the SUPPORT Trial -GDF15 across the BMI spectrum
GDF15 plays pivotal metabolic roles in nutritional stress and serves as a physiological regulator of energy balance. However, the patterns of GDF15 levels in underweight or obese patients with chronic heart failure (CHF) are not well-understood. We assessed serum GDF15 levels at baseline and 3 years...
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| Veröffentlicht in: | International journal of cardiology 2024-07, Vol.407, p.132093-132093, Article 132093 |
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| container_title | International journal of cardiology |
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| creator | Teramoto, Kanako Nochioka, Kotaro Sakata, Yasuhiko Kato, Eri Toda Nishimura, Kunihiro Shimokawa, Hiroaki Yasuda, Satoshi |
| description | GDF15 plays pivotal metabolic roles in nutritional stress and serves as a physiological regulator of energy balance. However, the patterns of GDF15 levels in underweight or obese patients with chronic heart failure (CHF) are not well-understood.
We assessed serum GDF15 levels at baseline and 3 years and the temporal changes in 940 Japanese patients (642 paired samples), as a sub-analysis of the SUPPORT trial (age 65.9 ± 10.1 years). The GDF15 levels were analyzed across BMI groups (underweight [ |
| doi_str_mv | 10.1016/j.ijcard.2024.132093 |
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We assessed serum GDF15 levels at baseline and 3 years and the temporal changes in 940 Japanese patients (642 paired samples), as a sub-analysis of the SUPPORT trial (age 65.9 ± 10.1 years). The GDF15 levels were analyzed across BMI groups (underweight [<18.5 kg/m2; n = 50], healthy weight [18.5–22.9; n = 27 5], overweight [23–24.9; n = 234], and obese [≥25; n = 381]), following WHO recommendations for the Asian-Pacific population. Landmark analysis at 3 years assessed the association between GDF15 levels and HF hospitalization or all-cause death.
Compared to the healthy weight group, the underweight group included more females (54.0%) with advanced HF (NYHA class III; 20.0%) and exhibited increased GDF15 level (1764 pg/mL [IQR 1067-2633]). Obese patients, younger (64.2 years) and diabetic (53%), had a similar GDF15 level to the healthy weight group. A higher baseline GDF15 level was associated with worse outcomes across the BMI spectrum. GDF15 increased by 208 [21–596] pg/mL over 3 years, with the most substantial increase observed in the underweight group (by +28.9% [6.2–81.0]). Persistently high GDF15 levels (≥1800 pg/mL) was independently associated with worse outcomes after 3 years (adjusted HR 1.8 [95%CI 1.1–2.9]).
In underweight patients with CHF, GDF15 level was elevated at baseline and experienced the most significant increase over 3 years. Its consistent elevation suggested a worse outcome.
•Underweight patients with chronic HF had elevated serum GDF15 levels.•Increased GDF15 is a risk of HF hospitalization or death across the BMI spectrum.•Over 3 years, GDF15 increased overall, with the largest increase in underweights.•Persistently elevated GDF15 was linked to BMI decline and higher nutritional risk.•Long-term exposure to elevated GDF15 levels was associated with worse outcomes.•Extended monitoring of GDF15 may offer non-cardio-specific patient conditions.</description><identifier>ISSN: 0167-5273</identifier><identifier>EISSN: 1874-1754</identifier><identifier>DOI: 10.1016/j.ijcard.2024.132093</identifier><identifier>PMID: 38663803</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; Biomarkers - blood ; Body Mass Index ; Cachexia ; Chronic Disease ; Chronic heart failure ; Female ; Follow-Up Studies ; Growth Differentiation Factor 15 - blood ; Growth differentiation factor-15 ; Heart Failure - blood ; Heart Failure - epidemiology ; Humans ; Male ; Middle Aged ; Obesity ; Obesity - blood ; Obesity - epidemiology ; Thinness - blood ; Thinness - epidemiology</subject><ispartof>International journal of cardiology, 2024-07, Vol.407, p.132093-132093, Article 132093</ispartof><rights>2023</rights><rights>Copyright © 2023. Published by Elsevier B.V.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-3354cff0d89741242ad3d83bf33489a8c4b87f66a414177487b96a93fa1506f93</citedby><cites>FETCH-LOGICAL-c362t-3354cff0d89741242ad3d83bf33489a8c4b87f66a414177487b96a93fa1506f93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijcard.2024.132093$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38663803$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Teramoto, Kanako</creatorcontrib><creatorcontrib>Nochioka, Kotaro</creatorcontrib><creatorcontrib>Sakata, Yasuhiko</creatorcontrib><creatorcontrib>Kato, Eri Toda</creatorcontrib><creatorcontrib>Nishimura, Kunihiro</creatorcontrib><creatorcontrib>Shimokawa, Hiroaki</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>SUPPORT Trial Investigators</creatorcontrib><title>Growth differentiation factor-15 and metabolic features in chronic heart failure: Insights from the SUPPORT Trial -GDF15 across the BMI spectrum</title><title>International journal of cardiology</title><addtitle>Int J Cardiol</addtitle><description>GDF15 plays pivotal metabolic roles in nutritional stress and serves as a physiological regulator of energy balance. However, the patterns of GDF15 levels in underweight or obese patients with chronic heart failure (CHF) are not well-understood.
We assessed serum GDF15 levels at baseline and 3 years and the temporal changes in 940 Japanese patients (642 paired samples), as a sub-analysis of the SUPPORT trial (age 65.9 ± 10.1 years). The GDF15 levels were analyzed across BMI groups (underweight [<18.5 kg/m2; n = 50], healthy weight [18.5–22.9; n = 27 5], overweight [23–24.9; n = 234], and obese [≥25; n = 381]), following WHO recommendations for the Asian-Pacific population. Landmark analysis at 3 years assessed the association between GDF15 levels and HF hospitalization or all-cause death.
Compared to the healthy weight group, the underweight group included more females (54.0%) with advanced HF (NYHA class III; 20.0%) and exhibited increased GDF15 level (1764 pg/mL [IQR 1067-2633]). Obese patients, younger (64.2 years) and diabetic (53%), had a similar GDF15 level to the healthy weight group. A higher baseline GDF15 level was associated with worse outcomes across the BMI spectrum. GDF15 increased by 208 [21–596] pg/mL over 3 years, with the most substantial increase observed in the underweight group (by +28.9% [6.2–81.0]). Persistently high GDF15 levels (≥1800 pg/mL) was independently associated with worse outcomes after 3 years (adjusted HR 1.8 [95%CI 1.1–2.9]).
In underweight patients with CHF, GDF15 level was elevated at baseline and experienced the most significant increase over 3 years. Its consistent elevation suggested a worse outcome.
•Underweight patients with chronic HF had elevated serum GDF15 levels.•Increased GDF15 is a risk of HF hospitalization or death across the BMI spectrum.•Over 3 years, GDF15 increased overall, with the largest increase in underweights.•Persistently elevated GDF15 was linked to BMI decline and higher nutritional risk.•Long-term exposure to elevated GDF15 levels was associated with worse outcomes.•Extended monitoring of GDF15 may offer non-cardio-specific patient conditions.</description><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>Body Mass Index</subject><subject>Cachexia</subject><subject>Chronic Disease</subject><subject>Chronic heart failure</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Growth Differentiation Factor 15 - blood</subject><subject>Growth differentiation factor-15</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - epidemiology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity - blood</subject><subject>Obesity - epidemiology</subject><subject>Thinness - blood</subject><subject>Thinness - epidemiology</subject><issn>0167-5273</issn><issn>1874-1754</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctu1DAUhi1ERYfCGyDkJZsMduzENgskKHQ6UlErmK4txxfiURJPbQfEW_DIeJqWZVdHOuf7z-0H4A1Ga4xw-36_9nutolnXqKZrTGokyDOwwpzRCrOGPgergrGqqRk5BS9T2iOEqBD8BTglvG0JR2QF_m5i-J17aLxzNtope5V9mKBTOodY4QaqycDRZtWFwWvorMpztAn6Ceo-hqnkeqtiLgo_lMoHuJ2S_9nnBF0MI8y9hT9ub26uv-_gLno1wGrz5eLYV8eQ0n3987ctTAerc5zHV-DEqSHZ1w_xDNxefN2dX1ZX15vt-aerSpO2zhUhDdXOIcMFo7imtTLEcNI5QigXimvacebaVlFMMWOUs060ShCncINaJ8gZeLf0PcRwN9uU5eiTtsOgJhvmJAmiTFDcEFxQuqD3G0fr5CH6UcU_EiN59ELu5eKFPHohFy-K7O3DhLkbrfkvenx-AT4ugC13_vI2yqS9nbQ1PpZnSBP80xP-AetAm4Q</recordid><startdate>20240715</startdate><enddate>20240715</enddate><creator>Teramoto, Kanako</creator><creator>Nochioka, Kotaro</creator><creator>Sakata, Yasuhiko</creator><creator>Kato, Eri Toda</creator><creator>Nishimura, Kunihiro</creator><creator>Shimokawa, Hiroaki</creator><creator>Yasuda, Satoshi</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20240715</creationdate><title>Growth differentiation factor-15 and metabolic features in chronic heart failure: Insights from the SUPPORT Trial -GDF15 across the BMI spectrum</title><author>Teramoto, Kanako ; Nochioka, Kotaro ; Sakata, Yasuhiko ; Kato, Eri Toda ; Nishimura, Kunihiro ; Shimokawa, Hiroaki ; Yasuda, Satoshi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-3354cff0d89741242ad3d83bf33489a8c4b87f66a414177487b96a93fa1506f93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>Body Mass Index</topic><topic>Cachexia</topic><topic>Chronic Disease</topic><topic>Chronic heart failure</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Growth Differentiation Factor 15 - blood</topic><topic>Growth differentiation factor-15</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - epidemiology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity - blood</topic><topic>Obesity - epidemiology</topic><topic>Thinness - blood</topic><topic>Thinness - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Teramoto, Kanako</creatorcontrib><creatorcontrib>Nochioka, Kotaro</creatorcontrib><creatorcontrib>Sakata, Yasuhiko</creatorcontrib><creatorcontrib>Kato, Eri Toda</creatorcontrib><creatorcontrib>Nishimura, Kunihiro</creatorcontrib><creatorcontrib>Shimokawa, Hiroaki</creatorcontrib><creatorcontrib>Yasuda, Satoshi</creatorcontrib><creatorcontrib>SUPPORT Trial Investigators</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Teramoto, Kanako</au><au>Nochioka, Kotaro</au><au>Sakata, Yasuhiko</au><au>Kato, Eri Toda</au><au>Nishimura, Kunihiro</au><au>Shimokawa, Hiroaki</au><au>Yasuda, Satoshi</au><aucorp>SUPPORT Trial Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Growth differentiation factor-15 and metabolic features in chronic heart failure: Insights from the SUPPORT Trial -GDF15 across the BMI spectrum</atitle><jtitle>International journal of cardiology</jtitle><addtitle>Int J Cardiol</addtitle><date>2024-07-15</date><risdate>2024</risdate><volume>407</volume><spage>132093</spage><epage>132093</epage><pages>132093-132093</pages><artnum>132093</artnum><issn>0167-5273</issn><eissn>1874-1754</eissn><abstract>GDF15 plays pivotal metabolic roles in nutritional stress and serves as a physiological regulator of energy balance. However, the patterns of GDF15 levels in underweight or obese patients with chronic heart failure (CHF) are not well-understood.
We assessed serum GDF15 levels at baseline and 3 years and the temporal changes in 940 Japanese patients (642 paired samples), as a sub-analysis of the SUPPORT trial (age 65.9 ± 10.1 years). The GDF15 levels were analyzed across BMI groups (underweight [<18.5 kg/m2; n = 50], healthy weight [18.5–22.9; n = 27 5], overweight [23–24.9; n = 234], and obese [≥25; n = 381]), following WHO recommendations for the Asian-Pacific population. Landmark analysis at 3 years assessed the association between GDF15 levels and HF hospitalization or all-cause death.
Compared to the healthy weight group, the underweight group included more females (54.0%) with advanced HF (NYHA class III; 20.0%) and exhibited increased GDF15 level (1764 pg/mL [IQR 1067-2633]). Obese patients, younger (64.2 years) and diabetic (53%), had a similar GDF15 level to the healthy weight group. A higher baseline GDF15 level was associated with worse outcomes across the BMI spectrum. GDF15 increased by 208 [21–596] pg/mL over 3 years, with the most substantial increase observed in the underweight group (by +28.9% [6.2–81.0]). Persistently high GDF15 levels (≥1800 pg/mL) was independently associated with worse outcomes after 3 years (adjusted HR 1.8 [95%CI 1.1–2.9]).
In underweight patients with CHF, GDF15 level was elevated at baseline and experienced the most significant increase over 3 years. Its consistent elevation suggested a worse outcome.
•Underweight patients with chronic HF had elevated serum GDF15 levels.•Increased GDF15 is a risk of HF hospitalization or death across the BMI spectrum.•Over 3 years, GDF15 increased overall, with the largest increase in underweights.•Persistently elevated GDF15 was linked to BMI decline and higher nutritional risk.•Long-term exposure to elevated GDF15 levels was associated with worse outcomes.•Extended monitoring of GDF15 may offer non-cardio-specific patient conditions.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38663803</pmid><doi>10.1016/j.ijcard.2024.132093</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biomarkers - blood Body Mass Index Cachexia Chronic Disease Chronic heart failure Female Follow-Up Studies Growth Differentiation Factor 15 - blood Growth differentiation factor-15 Heart Failure - blood Heart Failure - epidemiology Humans Male Middle Aged Obesity Obesity - blood Obesity - epidemiology Thinness - blood Thinness - epidemiology |
| title | Growth differentiation factor-15 and metabolic features in chronic heart failure: Insights from the SUPPORT Trial -GDF15 across the BMI spectrum |
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