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Very high GDF15 levels are found in thalassaemia, where growth, energy balance and neuroendocrine function are impaired. We examined the relationships between GDF15 and anthropometric measures and endocrine status in \u03b2\u2010thalassaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>All \u03b2\u2010thalassaemia patients attending the thalassaemia unit of Colombo North Teaching Hospital for blood transfusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Anthropometric data, appetite scores, circulating GDF15, IGF, thyroid and reproductive hormone levels in 103 \u03b2\u2010thalassaemia patients were obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>GDF15 levels were markedly elevated in thalassaemia patients (24.2\u2010fold with \u03b2\u2010thalassaemia major compared with healthy controls). Among patients with \u03b2\u2010thalassaemia major, the relationship between GDF15 and body mass index (BMI) was curvilinear with all individuals with GDF15 levels above 24,000\u2009pg\/mL having a BMI below 20\u2009kg\/m<jats:sup>2<\/jats:sup>. After adjustment for BMI, age and Tanner stage, serum IGF1 concentrations correlated negatively with GDF15 in all thalassaemia patients (<jats:italic>\u03b2<\/jats:italic>\u2009=\u2009\u2212.027, <jats:italic>p<\/jats:italic>\u2009=\u2009.02). We found a significant positive relationship between GDF15 and gonadotropin (in both sexes) and testosterone (in males).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>GDF15 levels were markedly elevated in patients with \u03b2\u2010thalassaemia and its association with BMI is consistent with the known effect of GDF15 to reduce body weight. The inverse association between GDF15 with IGF1 levels may reflect a neuroendocrine impact of GDF15 or an indirect effect via impaired nutritional state. The positive association with testosterone in males and gonadotropins in both sexes, was surprising and should prompt further GDF15 studies on the hypothalamic pituitary gonadal axis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14897","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T16:33:51Z","timestamp":1676997231000},"page":"182-189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association of GDF15 levels with body mass index and endocrine status in \u03b2\u2010thalassaemia"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4000-7894","authenticated-orcid":false,"given":"Yanislava","family":"Karusheva","sequence":"first","affiliation":[{"name":"MRC Metabolic Diseases Unit, Wellcome\u2010MRC Institute of Metabolic Science University of Cambridge Cambridge UK"},{"name":"NIHR Cambridge Biomedical Research Centre Cambridge 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