PMID- 22815297
OWN - NLM
STAT- MEDLINE
DCOM- 20130417
LR  - 20211021
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Print)
IS  - 0149-5992 (Linking)
VI  - 35
IP  - 11
DP  - 2012 Nov
TI  - Growth-differentiation factor 15 predicts worsening of albuminuria in patients 
      with type 2 diabetes.
PG  - 2340-6
LID - 10.2337/dc12-0180 [doi]
AB  - OBJECTIVE: Development of micro- or macroalbuminuria is associated with increased 
      risk of cardiorenal complications, particularly in diabetes. For prevention of 
      transition to micro- or macroalbuminuria, more accurate prediction markers on top 
      of classical risk markers are needed. We studied a promising new marker, 
      growth-differentiation factor (GDF)-15, to predict transition to increasing stage 
      of albuminuria in type 2 diabetes mellitus (T2DM). In addition, we looked at the 
      GDF-15 potential in nondiabetic subjects with hypertension (HT). RESEARCH DESIGN 
      AND METHODS: Case and control subjects were selected from the PREVEND cohort, a 
      large (n = 8,592), prospective general population study on the natural course of 
      albuminuria, with >10 years of follow-up and repeated albuminuria measurements. 
      We found 24 T2DM and 50 HT case subjects transitioning from normo- to 
      macroalbuminuria and 9 T2DM and 25 HT case subjects transitioning from micro- to 
      macroalbuminuria (average follow-up 2.8 years). Control subjects with stable 
      albuminuria were pair matched for age, sex, albuminuria status, and diabetes 
      duration. GDF-15 was measured in samples prior to albuminuria transition. 
      RESULTS: Prior to transition, GDF-15 was significantly higher in case subjects 
      with T2DM than in control subjects (median [IQR] 1,288 pg/mL [885-1,546] vs. 948 
      pg/mL [660-1,016], P < 0.001). The odds ratio for transition in albuminuria 
      increased significantly per SD of GDF-15 (2.9 [95% CI 1.1-7.5], P = 0.03). GDF-15 
      also improved prediction of albuminuria transition, with significant increases in 
      C statistic (from 0.87 to 0.92, P = 0.03) and integrated discrimination 
      improvement (0.148, P = 0.001). In HT, GDF-15 was also independently associated 
      with transition in albuminuria stage (2.0 [1.1-3.5], P = 0.02) and improved 
      prediction significantly. CONCLUSIONS: We identified GDF-15 as a clinically 
      valuable marker for predicting transition in albuminuria stage in T2DM beyond 
      conventional risk markers. These findings were confirmed in nondiabetic HT 
      subjects.
FAU - Hellemons, Merel E
AU  - Hellemons ME
AD  - Department of Clinical Pharmacology, Division of Nephrology, University of 
      Groningen, University Medical Center of Groningen, Groningen, The Netherlands.
FAU - Mazagova, Magdalena
AU  - Mazagova M
FAU - Gansevoort, Ron T
AU  - Gansevoort RT
FAU - Henning, Robert H
AU  - Henning RH
FAU - de Zeeuw, Dick
AU  - de Zeeuw D
FAU - Bakker, Stephan J L
AU  - Bakker SJ
FAU - Lambers-Heerspink, Hiddo J
AU  - Lambers-Heerspink HJ
FAU - Deelman, Leo E
AU  - Deelman LE
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120718
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
RN  - 0 (Growth Differentiation Factor 15)
SB  - IM
MH  - Aged
MH  - Albuminuria/*metabolism
MH  - Diabetes Mellitus, Type 2/*metabolism
MH  - Female
MH  - Growth Differentiation Factor 15/*metabolism
MH  - Humans
MH  - Hypertension/physiopathology
MH  - Male
MH  - Middle Aged
PMC - PMC3476892
EDAT- 2012/07/21 06:00
MHDA- 2013/04/18 06:00
PMCR- 2013/11/01
CRDT- 2012/07/21 06:00
PHST- 2012/07/21 06:00 [entrez]
PHST- 2012/07/21 06:00 [pubmed]
PHST- 2013/04/18 06:00 [medline]
PHST- 2013/11/01 00:00 [pmc-release]
AID - dc12-0180 [pii]
AID - 0180 [pii]
AID - 10.2337/dc12-0180 [doi]
PST - ppublish
SO  - Diabetes Care. 2012 Nov;35(11):2340-6. doi: 10.2337/dc12-0180. Epub 2012 Jul 18.