GDF-15 as an integrative cardiometabolic biomarker

Area of Science:

• Biochemistry
• Clinical Chemistry
• Cardiology

Background:

• Growth Differentiation Factor 15 (GDF-15) is a stress-inducible cytokine elevated in cardiometabolic diseases like diabetes, obesity, and heart failure.
• It reflects shared pathophysiological processes including metabolic stress, inflammation, and tissue injury.

Purpose of the Study:

• To review GDF-15 as an integrative biomarker in cardiometabolic diseases.
• To discuss its clinical applications in risk assessment, prognosis, and monitoring.
• To highlight challenges and future directions for its clinical implementation.

Main Methods:

• Narrative review of clinical chemistry literature.
• Discussion of GDF-15 measurement techniques (immunoassays, mass spectrometry).
• Analysis of factors influencing biological variability and clinical interpretation.

Main Results:

• Increased GDF-15 is consistently linked to adverse outcomes (cardiovascular events, kidney failure, death) in various cardiometabolic conditions.
• Significant determinants of GDF-15 variability include age, sex, renal function, genetics, and comorbidities.
• Inter-assay variability and lack of assay standardization are major impediments to widespread clinical application.

Conclusions:

• GDF-15 is a potent integrative biomarker for metabolic stress, inflammation, and tissue injury in cardiometabolic diseases.
• Its clinical use can improve early risk stratification, personalize therapy, and monitor disease progression.
• Further research is needed for assay standardization, evidence-based reference intervals, and validated clinical decision limits.