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Updated: Sep 18, 2025

A High-Throughput Multiplexed Screening for Type 1 Diabetes, Celiac Diseases, and COVID-19
Published on: July 5, 2022
Dose-response relationship between circulating growth differentiation factor-15 and diabetes: a systematic review and
Jianshu Gao1, Hongli Liu2, Zhongwei Zhou3
1Department of Cardiology, The Yancheng Clinical College of Xuzhou Medical University, The First People's Hospital of Yancheng, Yancheng, Jiangsu, China.
Introduction:
Increasing evidence suggests that circulating growth differentiation factor-15 (GDF-15) may serve as a predictor of unfavorable clinical outcomes, but limited information is available on its relationship to diabetes risk. This meta-analysis was designed to evaluate quantitatively circulating GDF-15 in relation to diabetes prevalence.
Evidence Acquisition:
Our search encompassed the PubMed, Embase, and Web of Science databases from the inception dates to April 2024. Studies that provided data on diabetes prevalence across at least three distinct GDF-15 categories were eligible for inclusion in this meta-analysis.
Evidence Synthesis:
There were 27 independent studies from 25 articles included in this meta-analysis, involving 56,969 participants, 12,795 of whom were diabetic patients. The two-class meta-analysis showed participants with higher GDF-15 level had a higher diabetes prevalence [odds ratios (OR) 2.53, 95% confidence interval (CI) 2.09-3.05) than those with lower GDF-15 level. The diabetes prevalence increased by 63% (OR 1.63, 95% CI 1.47-1.80) when GDF-15 concentration was increased by 1 ng/mL, according to the dose-response meta-analysis. Nevertheless, the dose-response curve showed diabetes prevalence increased nonlinearly with increasing GDF-15 concentration (P nonlinearity <0.001), with a plateau or even a slight decrease after approximately 5.7 ng/mL of GDF-15 concentration. In the pooled estimates, considerable heterogeneity was observed and meta-regression analysis facilitated the interpretation of heterogeneity, which revealed significant correlations between diabetes prevalence and sample sizes (P<0.001) and hypertension prevalence (P=0.025).
Conclusions:
This meta-analysis reveals a positive and non-linear relationship between circulating GDF-15 and diabetes prevalence, which plateaus or slightly declines after reaching a certain level of GDF-15.
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