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The inflammatory and angiogenic effects of GDF-15 in atherosclerosis are controversial, and its correlation with the long asymptomatic phase of the disease is not well understood. Coronary artery calcium score (CACS) and ankle-brachial index (ABI) are sensitive markers of subclinical atherosclerosis. To date, only a few studies have examined the impact of GDF-15 on coronary artery calcification, and the association between GDF-15 and ABI has not been evaluated. Therefore, we aimed to investigate the possible relationship between serum GDF-15 concentrations and CACS and ABI in a Caucasian population sample of middle-aged (35\u201365\u00a0years) and elderly (&gt;\u200965\u00a0years) people. In addition to recording demographic and anthropometric characteristics, atherosclerotic risk factors, and laboratory tests including serum HDL-cholesterol, LDL-cholesterol, hemoglobin A1c (HbA1c), high-sensitivity C-reactive protein, and N-terminal pro-B-type natriuretic peptide (NT-proBNP); GDF-15 level, cardiac computed tomography, and ABI measurements were also performed. A total of 269 asymptomatic individuals (men,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009125; median age, 61.5 [IQR, 12.7] years) formed the basis of this study. Participants were divided into two groups according to their age (middle-aged,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009175 and elderly,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200994). Hypertension and diabetes mellitus were significantly more prevalent and CACS values and HbA1c, NT-proBNP, and GDF-15 levels were significantly higher (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) in the elderly group compared to the middle-aged group. Multivariate ridge regression analysis revealed a significant positive association between GDF-15 and CACS (middle-aged group: \u03b2\u2009=\u20090.072,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.333; elderly group: \u03b2\u2009=\u20090.148,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.003), and between GDF-15 and ABI (middle-aged group: \u03b2\u2009=\u20090.062,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.393; elderly group: \u03b2\u2009=\u20090.088,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.041) only in the elderly group. Our results show that GDF-15 is not only a useful biomarker of inflammation but can also predict early signs of asymptomatic atherosclerosis, especially in elderly people with chronic systemic inflammation associated with aging (inflammaging).\n                  <\/jats:p>","DOI":"10.1007\/s11357-023-00899-y","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:02:06Z","timestamp":1691366526000},"page":"1343-1350","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Association of growth and differentiation factor-15 with coronary artery calcium score and ankle-brachial index in a middle-aged and elderly Caucasian population sample free of manifest cardiovascular disease"],"prefix":"10.1007","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-3552","authenticated-orcid":false,"given":"Loretta Zsuzsa","family":"Kiss","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bal\u00e1zs Bence","family":"Ny\u00e1r\u00e1dy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9va","family":"P\u00e1llinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1rp\u00e1d","family":"Lux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1d\u00e1m Levente","family":"Jermendy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Csaba","family":"Csobay-Nov\u00e1k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e1l","family":"So\u00f3s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Szelid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya","family":"L\u00e1ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00e1szl\u00f3","family":"K\u0151hidai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elek","family":"Dinya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edit","family":"D\u00f3sa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e9la","family":"Merkely","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsolt","family":"Bagyura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,7]]},"reference":[{"key":"899_CR1","doi-asserted-by":"publisher","first-page":"946","DOI":"10.5966\/sctm.2013-0055","volume":"2","author":"J Corre","year":"2013","unstructured":"Corre J, H\u00e9braud B, Bourin P. 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