Associations of Growth Differentiation Factor 15 with Kidney Function in Frail and Pre-frail Older Individuals - The Mediating Role of Inflammation and Oxidative Stress

Q: What is the study’s main objective regarding GDF-15 and kidney function?

To examine the association between plasma GDF-15 and kidney function in frail and pre-frail older individuals, and to test whether inflammation and oxidative stress mediate this relationship.

Q: How was kidney dysfunction defined in the study?

Kidney dysfunction was indicated by an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m².

Q: What did the results show about GDF-15 and eGFR?

Higher GDF-15 levels were significantly negatively correlated with eGFR, and increased GDF-15 was associated with higher odds of kidney dysfunction.

Sep 30, 2026

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Cross-sectional analysis investigates plasma Growth Differentiation Factor 15 (GDF-15) in frail and pre-frail older individuals, focusing on links to kidney function and testing whether inflammation and oxidative stress mediate this association. Among 483 participants, plasma GDF-15 is measured by ELISA, kidney dysfunction defined by eGFR <60 mL/min/1.73m². Spearman correlations and multivariate logistic regression quantify associations, while structural equation modeling evaluates mediation through inflammatory and oxidative markers.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Frailty, pre-frailty, and kidney disease burden

GDF-15 as a stress and inflammation biomarker

Zhang et al. European Journal European Journal of Medical Research (2026) 31:40 [https://doi.org/10.1186/s40001-025-03619-8](https://doi.org/10.1186/s40001-025-03619-8 of Medical Research)[ of Medical Research](https://doi.org/10.1186/s40001-025-03619-8 of Medical Research) RESEARCH Open Access Associations of growth differentiation factor 15 with kidney function in frail and pre-frail older individuals: the mediating role of inflammation and oxidative stress Chi Zhang1†, Anying Bai2†, Yuting Kang3, Qiang Gao3, Jie Zhang4, Yushan Zhang4, Zehong Huo 1, Yingqi Zhao1, Hong Shi4, Ji Shen4* and Ping Zeng1* Abstract Background This cross-sectional investigation aimed to investigate the association of plasma Growth Differentiation Factor 15 (GDF-15) with kidney function in frail and pre-frail older individuals, and to further test the mediating roles of inflammation and oxidative stress. Methods 483 older adults (71 . 64 ± 6.07 years) with frailty or pre-frailty status were included. Plasma GDF-15 was measured using enzyme-linked immunosorbent assay. An estimated glomerular filtration rate (eGFR) < 60 mL/ min/1 . 73m2 was indicated as kidney dysfunction. Spearman correlation coefficients and multivariate logistic regression models were used to analyze the relationship between GDF-15 and kidney function. Structural equation modeling was used to explore the mediating factors. Results Both the absolute concentration and the ln-transformed concentration of GDF-15 were significantly negatively correlated with eGFR (both P < 0. 001) . In the multivariate logistic analysis, the odds ratio (OR) of kidney dysfunction for per 1-SD increase in GDF-15 was 1.36 (95% CI 1.04–1. 78) . Compared with the first quartile group of GDF-15, the OR of kidney dysfunction in the third quartile group was 2.74 (95% CI 1.44–5. 23, P = 0 . 002) . Tumor necrosis factor, malondialdehyde, and glutathione peroxidase mediated the relationship between GDF-15 and eGFR, with mediating proportions of 7 . 23%, 8 .41%, and 9. 83%, respectively. Conclusions Our findings suggest that high levels of GDF-15 are associated with lower eGFR in frail and pre-frail older individuals. GDF-15 may be related to kidney function through its involvement in inflammatory and oxidative stress responses. Keywords Growth differentiation factor 15, Glomerular filtration rate, Frailty, Mediation analysis †Chi Zhang and Anying Bai have contribute equally to this work. *Correspondence: Ji Shen [shenji4350@bjhmoh.cn](shenji4350@bjhmoh.cn)[ ](shenji4350@bjhmoh.cn)Ping Zeng [zengping2364@bjhmoh.cn](zengping2364@bjhmoh.cn) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by-nc-nd/4.0/](http://creativecommons.org/licenses/by-nc-nd/4.0/.)[.](http://creativecommons.org/licenses/by-nc-nd/4.0/.) Zhang et al. European Journal of Medical Research (2026) 31:40 Introduction Frailty and pre-frailty are highly prevalent syndromes among ol

FAQs

What is the study’s main objective regarding GDF-15 and kidney function?

To examine the association between plasma GDF-15 and kidney function in frail and pre-frail older individuals, and to test whether inflammation and oxidative stress mediate this relationship.

How was kidney dysfunction defined in the study?

Kidney dysfunction was indicated by an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m².

What did the results show about GDF-15 and eGFR?

Higher GDF-15 levels were significantly negatively correlated with eGFR, and increased GDF-15 was associated with higher odds of kidney dysfunction.

Sep 30, 2026

Upload by awa