GDF-15 A potential Biomarker of Diabetic Nephropathy in Iraq Patients with Chronic Kidney Disease

Rusul J. Abass and Intisar R. Sharba*
Department of Biology, faculty of Science, Kufa University, Al-Najaf province, Iraq

Corresponding Author: intisarsharba1@gmail.com; intisar.sharba@uokufa.edu.iq; Tel: 009647812855621
Recieved Date: October 03, 2020; Accepted Date: December 11, 2020; Published Date: 02 January 2021
Citation: Abass RJ and Sharba IR. GDF-15 A potential Biomarker of Diabetic Nephropathy in Iraq Patients with Chronic Kidney Disease. Trop J Nat Prod Res. 2020; 4(12):1081-1087.  https://doi.org/10.26538/tjnpr/v4i12.9
Copyright: © 2020 Abass and Sharba. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ABSTRACT

Growth differentiation factor-15 (GDF-15) expression increase exposure to tissue injury and has recently emerged as a useful biomarker for multiple diseases. This study is aimed at detecting serum GDF-15 in patients with chronic kidney disease (CKD) and assessing its value in the early diagnosis of diabetic nephropathy (DN). This cross-sectional study, involved a total of 60 patients with CKD aged 15-65 years, selected according to their albumin creatinine ratio (ACR): >30 mg/g (DN 42), and ACR <30 mg/g (without DN 18), patients were compared with 28 healthy participants. Serum GDF-15 level, hematological, and biochemical parameters were measured. In the DN group, levels of GDF-15, C-reactive protein (CRP), urea, and creatinine were significantly higher, while RBCs, Hb, and GFR were significantly lower (p < 0.05) in comparison with CKD non-DN group. GDF-15 was significantly negatively correlated with RBCs (R2=0.548), Hb (R2=0.559), and GFR (R2=0.466), while it was positively associated with CRP (R2=0.532). The receiver operating characteristic (ROC) curve to assess value of GDF-15 indicated AUC 87.7% ± 0.045 (95% CI 0.78–0.99, p<0.0001, 83.2-22.2% sensitivity and specificity). In multivariate analysis, GDF-15 is independently predictive for diagnosing DN (OR=1.01, 95% CI: 1.00-1.03, P=0.009). Furthermore, each of Hb, GFR, and CRP was found a predictor of GDF-15, (? =-0.42, 2.35, and 0.26). In conclusion, GDF-15 represents a risk biomarker in CKD patients with DN with associated anaemia and inflammation more than in CKD without DN. Additionally, GDF-15 can be a predictive risk stratification factor for achieving the end stage of diabetic kidney disease.

Keywords: Diabetic nephropathy, GDF-15, CKD, Anemia CKD.
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