A study published in the Journal of Cachexia, Sarcopenia, and Muscle has evaluated the associations between two biomarkers – growth differentiation factor 15 (GDF-15) and the difference between cystatin C- and creatinine-based estimated glomerular filtration rates (eGFRdiff) – and adverse outcomes in individuals with diabetes mellitus.
The observational cohort study included 638 Japanese adults with diabetes who were monitored over a 5-year period for chronic kidney disease (CKD) progression and mortality. Investigators stratified participants into three groups based on eGFRdiff and measured serum GDF-15 levels using ELISA. The analysis assessed correlations between the markers and clinical outcomes, adjusting for age, sex, glycated hemoglobin, albuminuria, and creatinine-based eGFR.
Patients with lower eGFRdiff values faced a dramatically higher risk of chronic kidney disease (CKD) progression. Specifically, each 10 mL/min/1.73 m² increase in eGFRdiff was associated with a 33 percent lower risk of CKD progression. Those with elevated GDF-15 levels were at a 235 percent higher risk of death for every 10-unit increase.
The results suggest that the two biomarkers could provide complementary disease insights. When used together, they could enhance precision in identifying which patients are most vulnerable to serious complications.
The study also evaluated additional markers derived from creatinine and cystatin C, including the sarcopenia index, creatinine-to-cystatin C ratio, and total body muscle mass index, most of which were also associated with adverse outcomes. Notably, eGFRdiff showed a significant correlation with GDF-15 even after adjustment for kidney function markers, suggesting a potential link to sarcopenia or frailty-related processes.
The authors note that these findings may have implications for risk stratification in diabetic kidney disease. However, limitations include the observational design, single time-point biomarker assessments, and lack of generalizability beyond the Japanese population.
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