{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:29:19Z","timestamp":1791253759110,"version":"4.1.0"},"reference-count":25,"publisher":"American Diabetes Association","issue":"7","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":4172,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2010,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>Growth deferentiation factor-15 (GDF-15) is involved in inflammation and apoptosis. Expression is induced in the heart in response to ischemia and in atherosclerotic plaques. The aim of this study was to investigate GDF-15 levels in relation to all-cause mortality, cardiovascular mortality and morbidity, decline in glomerular filtration rate (GFR), and progression toward end-stage renal disease (ESRD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>The study was a prospective observational follow-up study including 451 type 1 diabetic patients with diabetic nephropathy (274 men, aged 42.1 \u00b1 0.5 years [means \u00b1 SD], diabetes duration 28.3 \u00b1 8.9 years, GFR 76 \u00b1 33 ml\/min\/1.73 m2) and a control group of 440 patients with longstanding type 1 diabetes and persistent normoalbuminuria (232 men, aged 45.4 \u00b1 11.5 years, duration of diabetes 27.7 \u00b1 10.1 years). The patients were followed for 8.1 (0.0\u201312.9) years (median [range]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Among normoalbuminuric patients, GDF-15 above the median predicted an adjusted (age, systolic blood pressure [sBP], and estimated GFR) increased risk of all-cause mortality (hazard ratio [HR] 3.6 [95% CI 1.3\u201310.3]; P = 0.014). Among patients with diabetic nephropathy, higher (fourth quartile) versus lower (first quartile) GDF-15 levels predict all-cause mortality (covariate-adjusted [sex, age, smoking, blood pressure, A1C, cholesterol, GFR, N-terminal prohormone B-type natriuretic peptide, antihypertensive treatment, and previous cardiovascular events]; HR 4.86 [95% CI 1.37\u201317.30]) as well as fatal and nonfatal cardiovascular events (adjusted HR 5.59 [1.23\u201325.43] and 3.55 [1.08\u201311.64], respectively). In addition, higher GDF-15 levels predict faster decline in GFR (P &amp;lt; 0.001) but not development of ESRD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Higher levels of GDF-15 are a predictor of all-cause and cardiovascular mortality and morbidity in patients with diabetic nephropathy. Furthermore, higher levels of GDF-15 are associated with faster deterioration of kidney function.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc09-2174","type":"journal-article","created":{"date-parts":[[2010,4,1]],"date-time":"2010-04-01T03:55:22Z","timestamp":1270094122000},"page":"1567-1572","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":119,"title":["Plasma Growth Differentiation Factor-15 Independently Predicts All-Cause and Cardiovascular Mortality As Well As Deterioration of Kidney Function in Type 1 Diabetic Patients With Nephropathy"],"prefix":"10.2337","volume":"33","author":[{"given":"Maria","family":"Lajer","sequence":"first","affiliation":[{"name":"Steno Diabetes Center, Gentofte, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Jorsal","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center, Gentofte, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lise","family":"Tarnow","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center, Gentofte, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Henrik","family":"Parving","sequence":"additional","affiliation":[{"name":"Department of Medical Endocrinology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark;"},{"name":"Faculty of Health Science, University of Aarhus, Aarhus, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rossing","sequence":"additional","affiliation":[{"name":"Steno Diabetes Center, Gentofte, Denmark;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2010,3,31]]},"reference":[{"key":"2022031303215094000_B1","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1136\/bmj.313.7060.779","article-title":"Predictors of mortality in insulin 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