TY - JOUR
T1 - Diabetes, GDF-15 and incident heart failure
T2 - the atherosclerosis risk in communities study
AU - Echouffo-Tcheugui, Justin B.
AU - Daya, Natalie
AU - Ndumele, Chiadi E.
AU - Matsushita, Kunihiro
AU - Hoogeveen, Ron C.
AU - Ballantyne, Christie M.
AU - Coresh, Josef
AU - Shah, Amil M.
AU - Selvin, Elizabeth
N1 - Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services (under contract nos. (75N92022D00001, 75N92022D00002, 75N92022D00003, 75N92022D00004, 75N92022D00005). The content of this work is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. SomaLogic Inc. conducted the SomaScan assays in exchange for use of ARIC data. This work was supported in part by NIH/NHLBI grant R01 HL134320. JBE-T was supported by NIH/NHLBI grant K23 HL153774. ES was supported by NIH/NHLBI grant K24 HL152440 and NIH/NIDDK grant R01 DK089174. AMS was supported by NIH/NHLBI grants R01HL135008, R01HL143224, R01HL150342, R01HL148218 and K24HL152008. CEN was supported by NIH grant R01HL146907. ES, CEN and JBE-T were supported by AHA grant 20SFRN35120152.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2022/6
Y1 - 2022/6
N2 - Aims/hypothesis: Elevated circulating growth differentiation factor-15 (GDF-15), a marker of cellular stress, is associated with both heart failure (HF) and diabetes. However, it is unclear to what extent GDF-15 is associated with HF among individuals with and without diabetes. Methods: We evaluated 10,570 participants free of HF at Visit 3 (1993–1995) of the Atherosclerosis Risk in Communities study. We used Cox regression to evaluate the joint associations of GDF-15 and diabetes with incident HF. Models were adjusted for traditional cardiovascular risk factors. Results: Among a total of 10,570 individuals (mean age of 60.0 years, 54% women, 27% black adults), elevated GDF-15 (≥75th percentile) was more common in people with diabetes compared with those without diabetes (32.8% vs 23.6%, p<0.0001). During 23 years of follow-up, there were 2429 incident HF events. GDF-15 (in quartiles) was independently associated with HF among those with and without diabetes, with a stronger association among individuals with diabetes (p-for-diabetes–GDF-15 interaction = 0.034): HR for highest vs lowest GDF-15 quartile (reference): 1.64 (95% CI 1.41, 1.91) among those without diabetes and 1.72 (95% CI 1.32, 2.23) among those with diabetes. Individuals with diabetes and elevated GDF-15 had the highest risk of incident HF (HR 2.46; 95% CI 1.99, 3.03). After accounting for HF risk factors, GDF-15 provided additional prognostic information among participants with diabetes (ΔC statistic for model with vs model without GDF-15: +0.008, p = 0.001) and among those without diabetes (+0.006, p<0.0001). Conclusions/interpretation: In a community-based sample of US adults, GDF-15 provided complementary prognostic information on the HF risk, especially among individuals with diabetes. Graphical abstract: [Figure not available: see fulltext.]
AB - Aims/hypothesis: Elevated circulating growth differentiation factor-15 (GDF-15), a marker of cellular stress, is associated with both heart failure (HF) and diabetes. However, it is unclear to what extent GDF-15 is associated with HF among individuals with and without diabetes. Methods: We evaluated 10,570 participants free of HF at Visit 3 (1993–1995) of the Atherosclerosis Risk in Communities study. We used Cox regression to evaluate the joint associations of GDF-15 and diabetes with incident HF. Models were adjusted for traditional cardiovascular risk factors. Results: Among a total of 10,570 individuals (mean age of 60.0 years, 54% women, 27% black adults), elevated GDF-15 (≥75th percentile) was more common in people with diabetes compared with those without diabetes (32.8% vs 23.6%, p<0.0001). During 23 years of follow-up, there were 2429 incident HF events. GDF-15 (in quartiles) was independently associated with HF among those with and without diabetes, with a stronger association among individuals with diabetes (p-for-diabetes–GDF-15 interaction = 0.034): HR for highest vs lowest GDF-15 quartile (reference): 1.64 (95% CI 1.41, 1.91) among those without diabetes and 1.72 (95% CI 1.32, 2.23) among those with diabetes. Individuals with diabetes and elevated GDF-15 had the highest risk of incident HF (HR 2.46; 95% CI 1.99, 3.03). After accounting for HF risk factors, GDF-15 provided additional prognostic information among participants with diabetes (ΔC statistic for model with vs model without GDF-15: +0.008, p = 0.001) and among those without diabetes (+0.006, p<0.0001). Conclusions/interpretation: In a community-based sample of US adults, GDF-15 provided complementary prognostic information on the HF risk, especially among individuals with diabetes. Graphical abstract: [Figure not available: see fulltext.]
KW - Growth differentiation factor-15
KW - Heart failure
KW - Prediction
KW - Type 2 diabetes
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U2 - 10.1007/s00125-022-05678-6
DO - 10.1007/s00125-022-05678-6
M3 - Article
C2 - 35275240
AN - SCOPUS:85126146890
SN - 0012-186X
VL - 65
SP - 955
EP - 963
JO - Diabetologia
JF - Diabetologia
IS - 6
ER -