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- Title
Growth Differentiation Factor 15 as a Biomarker of Cardiovascular Risk in Chronic Musculoskeletal Pain.
- Authors
León-González, Rocío; Ortolá, Rosario; Carballo-Casla, Adrián; Sotos-Prieto, Mercedes; Buño-Soto, Antonio; Rodríguez-Sánchez, Isabel; Pastor-Barriuso, Roberto; Rodríguez-Artalejo, Fernando; García-Esquinas, Esther
- Abstract
Background It is unknown whether growth differentiation factor 15 (GDF-15) is associated with chronic musculoskeletal pain (CMP) and whether or not its association with incident cardiovascular disease (CVD) changes according to CMP status. Methods In total, 1 957 randomly selected adults aged ≥65 years without prior CVD were followed up between 2015 and 2023. CMP was classified according to its intensity, frequency, and interference with daily activities. The association between GDF-15 levels and CMP was assessed using linear models with progressive inclusion of potential confounders, whereas the association between GDF-15 and CVD risk was evaluated with Cox proportional hazard models with similar adjustment and interaction terms between GDF-15 and CMP. The incremental predictive performance of GDF-15 over standard predictors was evaluated using discrimination and risk reclassification metrics. Results GDF-15 concentrations were 6.90% (95% confidence interval [CI]: 2.56; 11.25) higher in individuals with CMP, and up to 8.89% (4.07; 15.71) and 15.79% (8.43; 23.16) higher in those with ≥3 CMP locations and interfering pain. These increased levels were influenced by a higher prevalence of cardiometabolic risk factors, functional impairments, depressive symptoms, and greater levels of inflammation in individuals with CMP. In fully adjusted models, a twofold increase in GDF-15 was associated with a 1.49 increased risk (95% CI: 1.08; 2.05) of a CVD event in individuals with CMP, but not among those without CMP (1.02 [0.77; 1.35]); p- interaction 0.041. Adding GDF-15 to models including the Framingham Risk Score improved predictive performance among individuals with CMP. Conclusions We provide evidence that GDF-15 could serve as a biomarker to assess CMP, as well as to predict CVD incidence in individuals with CMP.
- Subjects
GROWTH differentiation factors; PROPORTIONAL hazards models; DISEASE risk factors; MUSCULOSKELETAL pain; CHRONIC pain; CARDIOVASCULAR diseases
- Publication
Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 2024, Vol 79, Issue 8, p1
- ISSN
1079-5006
- Publication type
Article
- DOI
10.1093/gerona/glae163