Growth Differentiation Factor 15: a Possible Link Between Rheumatoid Arthritis and Atherosclerosis

Objective To explore the possible relation between serum growth differentiation factor 15 (GDF-15) level and carotid intima-media thickness (CIMT) test in patients with rheumatoid arthritis (RA). Background GDF-15 plays an important role in cell growth and apoptosis regulation. GDF-15 is connected to RA, suggesting that it is a proinflammatory cytokine and etiologic factor for both RA and cardiovascular disease. Patients and methods This was a case–control study conducted on 50 patients with RA who were compared with 25 sex-matched and age-matched control group. GDF-15 levels were measured in blood samples from patients and controls by enzyme-linked immunosorbent assay, and CIMT was measured using Doppler ultrasonography. Medical data were collected regarding the patients' clinical manifestations, comorbidities, and treatments. The disease activity score-28 was used to evaluate the disease activity of RA. Results Median GDF-15 level showed a significant increase in patients with RA (246.3 pg/ml) compared with controls (130.6 pg/ml), with P value less than 0.001. Right CIMT and left CIMT were significantly higher in patients with RA (P = 0.016 and 0.006, respectively). GDF-15 level showed a significant positive correlation with CIMT (P < 0.05). Age, disease duration, total cholesterol, and GDF-15 were independent risk factors for an elevated CIMT, with an odds ratio of 5.376, 4.659, 4.472, 1.905, 8.816, and 5.366, respectively. Conclusion Patients with RA had considerably greater levels of GDF-15 and CIMT than controls. Furthermore, in RA, GDF-15 was linked to an increased risk of subclinical atherosclerosis in those patients.