Relationship Between Plasma Growth Differentiation Factor-15 Level and Estimated Glomerular Filtration Rate in Type 2 Diabetes Patients with and Without Albuminuria

Aim: To assess the relationship between growth differentiation factor-15 (GDF-15) levels and estimated glomerular filtration rate (eGFR) in type 2 diabetes mellitus (DM) patients with and without albuminuria.

Methods: We examined 324 patients with type 2 DM in a cross-sectional study. eGFR was determined using equations from creatinine (eGFR) and the combination of creatinine and cystatin C (eGFR). The patients were classified into two groups based on urinary albumin: creatinine ratio (ACR): the normoalbuminuria group (urinary ACR < 30 mg/g) and the albuminuria group (urinary ACR ≥ 30 mg/g).

Results: In individuals both with and without albuminuria, higher GDF-15 levels were associated with lower eGFR and eGFR. Plasma GDF-15 levels were inversely correlated with eGFR in individuals both with and without albuminuria (γ = -0.624, p < 0.001 and γ = -0.509, p < 0.001, respectively). A multiple regression analysis showed that GDF-15 levels were significantly associated with eGFR after adjusting for age, sex and other confounders, including urinary ACR as a continuous or categorical variable (β = -0.309, p < 0.001 and β = -0.318, p < 0.001, respectively). Similarly, these results were replicated when eGFR was considered instead of eGFR in correlation and regression analyses.

Conclusion: GDF-15 levels were inversely associated with eGFR in patients with type 2 DM. This relationship was independent of albuminuria status.