Abstract
Objective
Our aim in this study was to identify the associations between growth differentiation
factor 15 (GDF15) and type 2 diabetes mellitus (T2DM) complications in a community-based
population in China.
Methods
Based on a cross-sectional study registered in the National Basic Public Health Service
for disease management of Changshu in China, a total of 1,689 T2DM patients were enrolled
and tested further for plasma GDF15 levels. Macrovascular (cardiovascular disease
and diabetic foot) and microvascular (diabetic kidney disease [DKD], diabetic retinopathy
and neuropathy) complications were evaluated. Logistic regression models were conducted
to identify the associations of GDF15 with the risk of diabetic complications, and
linear regression models were used to assess relationships between GDF15 and other
clinical features.
Results
Overall, 459 of the 1,689 T2DM patients (27.18%) had complications. GDF15 levels were
significantly higher in patients with any type of complication compared with their
counterparts. With each standard deviation increase of base 10 logarithms of GDF15
(lg-GDF15), the risk of overall complications increased by 1.17-fold (95% confidence
interval [CI], 1.03 to 1.32). In contrast to macrovascular complications, associations
of GDF15 with microvascular complications appeared to be stronger (adjusted odds ratio
[OR], 1.24; 95% CI, 1.08 to 1.43), especially for DKD (adjusted OR, 1.51; 95% CI,
1.19 to 1.93). Subgroup analyses showed that the strength of association between GDF15
and complications varied by distinct age and T2DM duration subgroups. Patients with
2 or more types of complications had higher levels of GDF15 than those with fewer
types of complications. Also, linear relationships were identified between GDF15 and
several liver and kidney function indices.
Conclusion
Higher GDF15 levels were associated with T2DM complications, especially DKD. GDF15
may serve as a biomarker for monitoring the deterioration of T2DM.
Résumé
Objectifs
L’objectif de notre étude était de cerner les associations entre le facteur de différenciation
de croissance 15 (GDF15, de l’anglais growth differentiation factor 15) 15 et les complications liées au diabète sucré de type 2 (DST2) d’une population
chinoise.
Méthodes
Selon une étude transversale sur la prise en charge de la maladie du National Basic
Public Health Service de Changshu, en Chine, les 1689 patients atteints du DST2 inscrits
ont subi des analyses de laboratoire pour déterminer les concentrations plasmatiques
du GDF15. Nous avons évalué les complications macrovasculaires (maladie cardiovasculaire
et pied diabétique) et microvasculaires (néphropathie diabétique [ND], rétinopathie
et neuropathie diabétiques). Nous avons effectué une régression logistique pour cerner
les associations entre le GDF15 et le risque de complications liées au diabète, et
utilisé une régression linéaire pour évaluer les relations entre le GDF15 et les autres
caractéristiques cliniques.
Résultats
Dans l’ensemble, 459 des 1689 patients atteints du DST2 (27,18 %) avaient des complications.
Les concentrations du GDF15 étaient significativement plus élevées chez les patients
de tout type de complications que leurs homologues. À chaque augmentation de l’écart
type des logarithmes de base 10 du GDF15 (lg-GDF15), le risque de complications globales
augmentait de 1,17 fois (intervalle de confiance [IC] à 95 %, de 1,03 à 1,32). Contrairement
aux complications macrovasculaires, les associations du GDF15 aux complications microvasculaires
semblaient être plus fortes (rapport de cotes ajusté [RC], 1,24; IC à 95 %, de 1,08
à 1,43), particulièrement pour la ND (RC ajusté, 1,51; IC à 95 %, de 1,19 à 1,93).
Les analyses en sous-groupes montraient que la force de l’association entre le GDF15
et les complications variaient en fonction des sous-groupes d’âge distincts et de
durée du DST2. Les patients qui avaient 2 types ou plus de complications avaient des
concentrations plus élevées de GDF15 que ceux qui avaient un moins grand nombre de
types de complications. De plus, nous avons observé des relations linéaires entre
le GDF15 et plusieurs paramètres des bilans hépatique et rénal.
Conclusion
Les concentrations plus élevées de GDF15 étaient associées aux complications liées
au DST2, particulièrement la ND.
Keywords
Mots clés
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Article info
Publication history
Published online: September 13, 2022
Accepted:
September 3,
2022
Received in revised form:
September 1,
2022
Received:
March 26,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Canadian Diabetes Association.