Growth differentiating factor-15 and adiposity in young adults: The African-PREDICT study

Circulating growth differentiation factor-15 (GDF-15) is a stress-responsive cytokine that increases in older individuals with established cardiovascular disease (CVD) and obesity. To address potential targets in primary prevention, we aimed to determine whether body weight, waist circumference, waist/height ratio, body mass index (BMI), body surface area (BSA) and leptin associate with GDF-15 in young underweight, lean and overweight/obese (ow/ob) adults.

We included 1189 adults aged 20-30 years. We grouped participants as underweight (BMI ≤ 18 kg/m², n = 59), lean (BMI > 18 kg/m² and ≤25 kg/m²; n = 616) or ow/ob (BMI ≥ 25 kg/m²; n = 514) and determined serum GDF-15 and leptin levels. Body composition measurements, leptin and blood pressure readings were higher in the ow/ob group compared to the underweight and lean groups (all p < 0.0001). GDF-15 was higher in the underweight group compared to the lean and combined ow/ob groups (p = 0.041), and higher in obese (BMI ≥ 30 kg/m²) compared to overweight (p = 0.002) individuals. In multiple regression analysis, we found positive associations (all p ≤ 0.020) of body weight (adj. R² = 0.398; β = 0.11), waist circumference (adj. R² = 0.271; β = 0.11), waist/height ratio (adj. R² = 0.168; β = 0.14), BMI (adj. R² = 0.263; β = 0.14), BSA (adj. R² = 0.508; β = 0.083) and leptin (adj. R² = 0.622; β = 0.10) with GDF-15 in the ow/ob group. However, waist circumference (adj. R² = 0.536; β = -0.45), waist/height ratio (adj. R² = 0.471; β = -0.51) and leptin (adj. R² = 434; β = -0.25) associated inversely with GDF-15 in the underweight group (all p < 0.050).

Our findings may suggest that in young adults with either underweight or excess adiposity, increased GDF-15 levels may contribute to the development of future cardiovascular health risks associated with pro-inflammation.