GDF-15 plasma levels in chronic obstructive pulmonary disease are associated with subclinical coronary artery disease.
GDF-15 plasma levels in chronic obstructive pulmonary disease are associated with subclinical coronary artery disease.
复制标题
慢性阻塞性肺疾病患者GDF-15血浆水平与亚临床冠状动脉疾病相关
DOI：
10.1186/s12931-017-0521-1
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发表时间：
2017-02-28
影响因子：
5.8
通讯作者：
COPDGene Investigators
中科院分区：
文献类型：
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作者：
Martinez CH;Freeman CM;Nelson JD;Murray S;Wang X;Budoff MJ;Dransfield MT;Hokanson JE;Kazerooni EA;Kinney GL;Regan EA;Wells JM;Martinez FJ;Han MK;Curtis JL;COPDGene Investigators
Growth differentiation factor-15 (GDF-15), a cytokine associated with cardiovascular mortality, increases during chronic obstructive pulmonary disease (COPD) exacerbations, but any role in stable COPD is unknown. We tested associations between GDF-15 and subclinical coronary atherosclerosis, assessed by coronary artery calcium (CAC) score, in COPD subjects free of clinical cardiovascular disease (CVD). Cross-sectional analysis of COPD participants (GOLD stages 2–4) in the COPDGene cohort without CVD at enrollment, using baseline CAC (from non-EKG-gated chest computed tomography) and plasma GDF-15 (by custom ELISA). We used multinomial logistic modeling of GDF-15 associations with CAC, adjusting for demographics, baseline risk (calculated using the HEART: Personal Heart Early Assessment Risk Tool (Budoff et al. 114:1761-1791, 2006) score), smoking history, measures of airflow obstruction, emphysema and airway disease severity. Among 694 participants with COPD (47% women, mean age 63.6 years) mean GDF-15 was 1,304 pg/mL, and mean CAC score was 198. Relative to the lower GDF-15 tertile, higher tertiles showed bivariate association with increasing CAC score (mid tertile odds ratio [OR] 1.80, 95% confidence interval [CI] 1.29, 2.51; higher tertile OR 2.86, CI 2.04, 4.02). This association was maintained after additionally adjusting for baseline CVD risk, for co-morbidities and descriptors of COPD severity and impact, markers of cardiac stress (N-terminal pro–B-type natriuretic peptide, troponin T) and of inflammation (Interleukin-6), and in subgroup analysis excluding men, diabetics, current smokers or those with limited ambulation. In ever-smokers with COPD free of clinical CVD, GDF-15 contributes independently to subclinical coronary atherosclerosis. ClinicalTrials.gov, NCT00608764. Registered 28 January 2008. The online version of this article (doi:10.1186/s12931-017-0521-1) contains supplementary material, which is available to authorized users.
