Circulating growth differentiation factor-15 concentration and hypertension risk: a dose-response meta-analysis
Zhengqing Yu, Jianshu Gao, Zhongwei Zhou, Li Li, Sanqiang Hu
Abstract
Background Growing evidence suggests that growth differentiation factor-15 (GDF-15) may contribute to adverse clinical outcomes, such as major cardiovascular events and all-cause mortality. However, there is little information about its relationship to hypertension. This meta-analysis aimed to quantitatively evaluate the relationship between circulating GDF-15 and hypertension prevalence. Methods Databases searched included PubMed, Web of Science, and Embase, from inception to August 2024. The inclusion criteria were studies reporting hypertension prevalence in at least three GDF-15 categories. Result A total of 24 studies from 21 articles with 35,904 participants and 23,925 hypertensive cases were included in this meta-analysis. Compared with individuals with a low level of circulating GDF-15, those with high GDF-15 level had a higher prevalence of hypertension [odds ratios (OR) 1.60, 95% confidence interval (CI) 1.37–1.88, P < 0.001). In the dose-response meta-analysis, the prevalence of hypertension increased by 24% with every 1 ng/ml increase in GDF-15 (OR 1.24, 95% CI 1.16–1.33, P < 0.001). However, the dose-response curve was nonlinear ( P -nonlinearity < 0.001), plateauing or even decreasing slightly after GDF-15 concentrations reached approximately 5.5 ng/ml. Significant heterogeneity was detected in the pooled analysis and meta-regression analysis suggested that participants’ age and the prevalence of diabetes significantly accounted for the heterogeneity. Conclusions Circulating GDF-15 is positively and non-linearly associated with the prevalence of hypertension, with a plateau or slight decline after reaching a certain GDF-15 dose. Systematic Review Registration: https://inplasy.com/inplasy-2023-3-0082/ , identifier (INPLASY202330082).