Growth differentiation factor 15 in patients with acromegaly: a case-control study

Hayri Bostan; Sema Hepsen; Umran Gul; Hakan Duger; Serdar Kayıhan; Aykut Cimsir; Ozgur Ozcelik; Unsal İlknur Ozturk; Murat Calapkulu; Bekir Ucan; Erman Cakal; Muhammed Kizilgul

doi:10.1530/endoabs.99.EP351

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Endocrine Abstracts (2024) 99 EP351 | DOI: 10.1530/endoabs.99.EP351

ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)

Growth differentiation factor 15 in patients with acromegaly: a case-control study

Hayri Bostan ¹ , Sema Hepsen ² , Umran Gul ² , Hakan Duger ³ , Serdar Kayıhan ² , Aykut Cimsir ² , Özgür Özçelik ² , İlknur Ozturk Unsal ² , Murat Calapkulu ⁴ , Bekir Ucan ² , Erman Cakal ² & Muhammed Kizilgul ²

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¹Canakkale Mehmet Akif Ersoy State Hospital, Endocrinology and Metabolism, Turkey; ²Ankara Etlik City Hospital, Endocrinology and Metabolism, Turkey; ³Defa Life Hospital, Endocrinology and Metabolism, Turkey; ⁴Igdir State Hospital, Endocrinology and Metabolism, Turkey

Background: It was previously shown that the levels of several biomarkers increase due to acromegaly disease-related inflammation and that some markers are parallel to the activity of the disease. It was also known that growth differentiation factor 15 (GDF-15) is increased in several cardiovasculary inflammatory and metabolic diseases. The present study aimed to investigate the possible relationship of GDF-15 with acromegaly disease activity by comparing it with healthy individuals.

Methods: This study was designed as a single-center case-control study. A total of 40 acromegaly patients (25 active/15 controlled) (47.7±9.4 years, 20 female/20 male) and 24 healthy, individuals (49.9±10.1 years, 13 female/11 male) with age-sex-body mass index (BMI) similar to the patient group were included in the study. Demographic and anthropometric data, metabolic parameters, growth hormone (GH), insulin-like growth factor-1 (IGF-1), and GDF-15 levels of the study population were studied.

Results: The median GDF-15 levels were significantly higher in patients with acromegaly compared to healthy subjects (HS) (280.4 (197.0-553.2) vs 213.3 (179.9-297.2) ng/l, P=0.01). Median fasting plasma glucose (FPG), HbA1c, and systolic and diastolic blood pressure levels were significantly higher in patients with acromegaly compared to HS (P<0.01). Patients with acromegaly were divided into two groups according to disease control status: active patient group (aPG) (n=25) and controlled patient group (cPG) (n=15). The duration of symptoms before diagnosis and the frequency of obesity diabetes, and hypertension were similar in both active and controlled acromegaly patients (P>0.05). Serum GDF-15 levels of these groups were comparable (P=0.39). Interestingly compared to HS, GDF-15 levels were significantly higher in cPG (P=0.01), whereas GDF-15 levels tended to be higher in aPG, but did not reach statistical significance (P=0.06) (Figure 1). GDF-15 levels were observed to be positively correlated with fasting plasma glucose (r=0.304, P=0.01) and HbA1c (r=0.292, P=0.02). In the linear regression analysis, no independent relationship was observed between GDF-15 levels and age, gender, BMI, HbA1c, systolic and diastolic blood pressures, GH, IGF-1, and serum lipid levels (P>0.05). When evaluated across the entire cohort, GDF-15 levels were found to be higher in diabetic patients compared to non-diabetic individuals (P=0.04).

Conclusions: Plasma GDF-15 levels were increased in the patients with acromegaly compared to healthy subjects. This increment may be due to accompanying diseases such as diabetes rather than a disease-specific effect.