A Multicenter Study for Establishing Reference Intervals of Serum GDF-15 Levels Based on the Chinese Population

Area of Science:

• Biochemistry
• Clinical Chemistry
• Human Physiology

Background:

• Growth Differentiation Factor 15 (GDF-15) is a cytokine associated with stress and various pathological conditions.
• Establishing population-specific reference intervals is crucial for accurate clinical interpretation.
• Previous data on GDF-15 reference intervals in Chinese populations are limited.

Purpose of the Study:

• To determine the reference intervals (RIs) for serum GDF-15 in a large, multicenter cohort of apparently healthy Chinese individuals.
• To investigate the influence of age and sex on GDF-15 levels in this population.
• To provide age- and sex-specific RIs for GDF-15.

Main Methods:

• Recruitment of 8,488 healthy Chinese subjects across six cities.
• Serum GDF-15 measurement using chemiluminescence immunoassay.
• Statistical analysis including Tukey's test for outliers, two-level nested ANOVA for age/sex partitioning, and non-parametric methods for RI determination.

Main Results:

• A total of 7,764 participants were analyzed after outlier exclusion.
• Serum GDF-15 levels showed a skewed distribution.
• GDF-15 concentrations significantly increased with age and were generally higher in males than females (except for the 18-29 age group).
• Age and sex showed significant influence on GDF-15 levels (SDRs 0.83 and <0.01, respectively).

Conclusions:

• Age- and sex-specific reference intervals for serum GDF-15 were successfully established for the Chinese population.
• GDF-15 levels in Chinese individuals are comparable to European populations, with notable sex-based differences.
• These findings support the use of tailored reference ranges for GDF-15 in clinical practice within China.