A study of biological and lifestyle factors, including within-subject variation, affecting concentrations of growth differentiation factor 15 in serum
Articolo
Data di Pubblicazione:
2018
Citazione:
A study of biological and lifestyle factors, including within-subject variation, affecting concentrations of growth differentiation factor 15 in serum / M. Krintus, F. Braga, M. Kozinski, S. Borille, J. Kubica, G. Sypniewska, M. Panteghini. - In: CLINICAL CHEMISTRY AND LABORATORY MEDICINE. - ISSN 1434-6621. - (2018 Nov 24). [Epub ahead of print] [10.1515/cclm-2018-0908]
Abstract:
Background
Growth differentiation factor 15 (GDF-15) is an emerging cardiovascular biomarker, and a fully automated immunoassay has recently become available. The objectives of the study were to identify biological and lifestyle factors affecting serum GDF-15 concentrations and derive robust reference intervals, and to estimate GDF-15 within-subject biological variation and derived indices.
Methods
A presumably healthy population of 533 questionnaire-screened adults was used to identify the biological and lifestyle determinants of serum GDF-15. Following stringent exclusion criteria, a final group of 173 individuals was selected to establish GDF-15 reference interval. Twenty-six healthy volunteers were enrolled in the biological variation substudy.
Results
Using a multiple regression model, age, B-type natriuretic peptide and C-reactive protein as well as smoking status were significantly related to serum GDF-15 concentrations. The upper reference limit (URL) for serum GDF-15 concentrations (90% confidence interval [CI]) was 866 ng/L (733–999 ng/L), with no sex-related difference. Although GDF-15 tended to increase with age, the weak dependence of marker from age does not justify age-related URL. The within-subject CV was 6.3% (95% CI, 4.5%–8.5%), with no sex difference in intraindividual variances. The reference change value (RCV) for GDF-15 was 23%, and two are the specimens required to ensure that the mean GDF-15 result is within ±10% of the individual’s homeostatic set point.
Conclusions
By identifying the main factors influencing serum GDF-15 concentrations, we robustly established the URL to be applied in adult population. As intraindividual variation of GDF-15 is relatively low, monitoring longitudinal changes in its concentrations over time using RCV can be a good alternative for interpreting GDF-15 in clinical setting.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
biological variation; growth differentiation factor 15; reference limits
Elenco autori:
M. Krintus, F. Braga, M. Kozinski, S. Borille, J. Kubica, G. Sypniewska, M. Panteghini
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