Circulating Growth Differentiation Factor 15 Is Associated with Diabetic Neuropathy

Background: Growth differentiation factor (GDF15) is a superfamily of transforming growth factor-beta which has been suggested to be correlated with various pathological conditions. The current study aimed to investigate the predicted role of circulating GDF15 in diabetic metabolism characteristics...

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Main Authors: Shao-Wen Weng, Wen-Chieh Chen, Feng-Chih Shen, Pei-Wen Wang, Jung-Fu Chen, Chia-Wei Liou
Format: Article
Language:English
Published: MDPI AG 2022-05-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/11/11/3033
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author Shao-Wen Weng
Wen-Chieh Chen
Feng-Chih Shen
Pei-Wen Wang
Jung-Fu Chen
Chia-Wei Liou
author_facet Shao-Wen Weng
Wen-Chieh Chen
Feng-Chih Shen
Pei-Wen Wang
Jung-Fu Chen
Chia-Wei Liou
author_sort Shao-Wen Weng
collection DOAJ
description Background: Growth differentiation factor (GDF15) is a superfamily of transforming growth factor-beta which has been suggested to be correlated with various pathological conditions. The current study aimed to investigate the predicted role of circulating GDF15 in diabetic metabolism characteristics and diabetic neuropathy. Methods: 241 diabetic patients and 42 non-diabetic subjects were included to participate in the study. The plasma GDF15 levels were measured using ELISA. Chronic kidney disease and albuminuria were defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guideline. The nerve conductive study (NCS) was performed with measurement of distal latency, amplitude, nerve conduction velocity (NCV), H-reflex, and F-wave studies. Results: The diabetic group had a significantly higher prevalence of chronic kidney disease and higher plasma GDF15 level. After adjusting for age and BMI, GDF15 was significantly positively correlated with waist circumference (<i>r</i> = 0.332, <i>p</i> = <0.001), hip circumference (<i>r</i> = 0.339, <i>p</i> < 0.001), HbA1c (<i>r</i> = 0.302, <i>p</i> < 0.001), serum creatine (<i>r</i> = 0.146, <i>p</i> = 0.017), urine albumin/creatinine ratio (<i>r</i> = 0.126, <i>p</i> = 0.040), and HOMA-IR (<i>r</i> = 0.166, <i>p</i> = 0.007). As to NCS, GDF15 was significantly correlated with all latency and amplitude of sensory and motor nerves, as well as F-wave and H-reflex latencies. The area under the curve (AUC) in predicting tibial motor nerve neuropathy (MNCV) in all subjects and in the diabetic group for GDF15 was 0.646 (<i>p</i> = 0.001) and 0.610 (<i>p</i> = 0.012), respectively; for HbA1c was 0.639 (<i>p</i> = 0.001) and 0.604 (<i>p</i> = 0.018), respectively. Predicting ulnar sensory nerve neuropathy for GDF15 was 0.639 (<i>p</i> = 0.001) and 0.658 (<i>p</i> = 0.001), respectively; for HbA1c was 0.545 (<i>p</i> = 0.307) and 0.545 (<i>p</i> = 0.335), respectively. Predicting median sensory nerve neuropathy for GDF15 was 0.633 (<i>p</i> = 0.007) and 0.611 (<i>p</i> = 0.032), respectively; for HbA1c was 0.631 (<i>p</i> = 0.008) and 0.607 (<i>p</i> = 0.038), respectively. Predicting CKD for GDF15 was 0.709 (95% CI, 0.648–0.771), <i>p</i> < 0.001) and 0.676 (95% CI, 0.605–0.746), <i>p</i> < 0.001), respectively; for HbA1c was 0.560 (95% CI, 0.493–0.627); <i>p</i> = 0.080) and 0.515 (95% CI, 0.441–0.588); <i>p</i> = 0.697), respectively. Conclusions: We suggest that there is a significant association between the increased serum GDF-15 level and metabolic parameters and diabetic neuropathy. Plasma GDF15 may be an independent predictor of diabetic neuropathy.
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spelling doaj.art-ec53bde91afa455d8db74df6b6090a702023-11-23T14:15:40ZengMDPI AGJournal of Clinical Medicine2077-03832022-05-011111303310.3390/jcm11113033Circulating Growth Differentiation Factor 15 Is Associated with Diabetic NeuropathyShao-Wen Weng0Wen-Chieh Chen1Feng-Chih Shen2Pei-Wen Wang3Jung-Fu Chen4Chia-Wei Liou5Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanDepartment of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, TaiwanCenter for Mitochondrial Research and Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, TaiwanBackground: Growth differentiation factor (GDF15) is a superfamily of transforming growth factor-beta which has been suggested to be correlated with various pathological conditions. The current study aimed to investigate the predicted role of circulating GDF15 in diabetic metabolism characteristics and diabetic neuropathy. Methods: 241 diabetic patients and 42 non-diabetic subjects were included to participate in the study. The plasma GDF15 levels were measured using ELISA. Chronic kidney disease and albuminuria were defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) guideline. The nerve conductive study (NCS) was performed with measurement of distal latency, amplitude, nerve conduction velocity (NCV), H-reflex, and F-wave studies. Results: The diabetic group had a significantly higher prevalence of chronic kidney disease and higher plasma GDF15 level. After adjusting for age and BMI, GDF15 was significantly positively correlated with waist circumference (<i>r</i> = 0.332, <i>p</i> = <0.001), hip circumference (<i>r</i> = 0.339, <i>p</i> < 0.001), HbA1c (<i>r</i> = 0.302, <i>p</i> < 0.001), serum creatine (<i>r</i> = 0.146, <i>p</i> = 0.017), urine albumin/creatinine ratio (<i>r</i> = 0.126, <i>p</i> = 0.040), and HOMA-IR (<i>r</i> = 0.166, <i>p</i> = 0.007). As to NCS, GDF15 was significantly correlated with all latency and amplitude of sensory and motor nerves, as well as F-wave and H-reflex latencies. The area under the curve (AUC) in predicting tibial motor nerve neuropathy (MNCV) in all subjects and in the diabetic group for GDF15 was 0.646 (<i>p</i> = 0.001) and 0.610 (<i>p</i> = 0.012), respectively; for HbA1c was 0.639 (<i>p</i> = 0.001) and 0.604 (<i>p</i> = 0.018), respectively. Predicting ulnar sensory nerve neuropathy for GDF15 was 0.639 (<i>p</i> = 0.001) and 0.658 (<i>p</i> = 0.001), respectively; for HbA1c was 0.545 (<i>p</i> = 0.307) and 0.545 (<i>p</i> = 0.335), respectively. Predicting median sensory nerve neuropathy for GDF15 was 0.633 (<i>p</i> = 0.007) and 0.611 (<i>p</i> = 0.032), respectively; for HbA1c was 0.631 (<i>p</i> = 0.008) and 0.607 (<i>p</i> = 0.038), respectively. Predicting CKD for GDF15 was 0.709 (95% CI, 0.648–0.771), <i>p</i> < 0.001) and 0.676 (95% CI, 0.605–0.746), <i>p</i> < 0.001), respectively; for HbA1c was 0.560 (95% CI, 0.493–0.627); <i>p</i> = 0.080) and 0.515 (95% CI, 0.441–0.588); <i>p</i> = 0.697), respectively. Conclusions: We suggest that there is a significant association between the increased serum GDF-15 level and metabolic parameters and diabetic neuropathy. Plasma GDF15 may be an independent predictor of diabetic neuropathy.https://www.mdpi.com/2077-0383/11/11/3033growth differentiation factor 15diabetic neuropathynerve conductive studytype 2 DM
spellingShingle Shao-Wen Weng
Wen-Chieh Chen
Feng-Chih Shen
Pei-Wen Wang
Jung-Fu Chen
Chia-Wei Liou
Circulating Growth Differentiation Factor 15 Is Associated with Diabetic Neuropathy
Journal of Clinical Medicine
growth differentiation factor 15
diabetic neuropathy
nerve conductive study
type 2 DM
title Circulating Growth Differentiation Factor 15 Is Associated with Diabetic Neuropathy
title_full Circulating Growth Differentiation Factor 15 Is Associated with Diabetic Neuropathy
title_fullStr Circulating Growth Differentiation Factor 15 Is Associated with Diabetic Neuropathy
title_full_unstemmed Circulating Growth Differentiation Factor 15 Is Associated with Diabetic Neuropathy
title_short Circulating Growth Differentiation Factor 15 Is Associated with Diabetic Neuropathy
title_sort circulating growth differentiation factor 15 is associated with diabetic neuropathy
topic growth differentiation factor 15
diabetic neuropathy
nerve conductive study
type 2 DM
url https://www.mdpi.com/2077-0383/11/11/3033
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AT peiwenwang circulatinggrowthdifferentiationfactor15isassociatedwithdiabeticneuropathy
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