Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2473
Peer-review started: January 30, 2020
First decision: April 21, 2020
Revised: May 9, 2020
Accepted: May 13, 2020
Article in press: May 13, 2020
Published online: June 26, 2020
Processing time: 145 Days and 21.2 Hours
Multiple system atrophy (MSA) is a serious progressive neurodegenerative disease. The early diagnosis of MSA is very difficult, and diagnostic biomarkers are limited. There is an urgent need for biomarkers for early diagnosis, prognostic prediction of disease progression, and monitoring the therapeutic response.
Growth differentiation factor 15 (GDF15) is a member of the transforming growth factor-β superfamily. Abnormal concentrations of GDF15 are considered to have a close association with neurodegenerative diseases and might be a potential biomarker for early diagnosis. It has not been previously reported whether serum GDF15 levels are also higher in patients with MSA.
This study aimed to determine serum GDF15 levels, related factors and their potential diagnostic value in MSA patients.
A case-control study was conducted, which included 49 MSA patients, 50 Parkinson’s disease (PD) patients and 50 healthy controls. Serum GDF15 levels were measured by human enzyme-linked immunosorbent assay and the differences between the MSA, PD and control groups were analyzed.
Serum GDF15 levels were significantly higher in MSA patients than in PD patients and healthy controls (P = 0.000). Males and those with a disease duration of more than three years showed higher serum GDF15 levels (P = 0.043 and 0.000; respectively). Serum GDF15 levels might be a potential diagnostic biomarker for MSA patients compared with healthy controls and PD patients (cutoff: 470.42 pg/mL, sensitivity: 85.7%, specificity: 88.0%; cutoff: 1075.91 pg/mL, sensitivity: 51.0%, specificity: 96.0%; respectively).
We found that serum GDF15 levels in MSA patients were significantly higher compared with PD patients and healthy controls. Male patients with MSA had higher serum GDF15 levels than female patients, and serum GDF15 levels were also higher in those with disease duration of more than 3 years. The receiver-operating characteristic curve analysis revealed that serum GDF15 levels had high specificity, while the sensitivity seemed unsatisfactory in the differential diagnosis between MSA and PD. Serum GDF15 levels might be a potential diagnostic biomarker for MSA patients.
This study revealed that serum GDF15 might be a potential diagnostic biomarker in MSA. To further explore whether serum GDF15 levels are consistent with clinical manifestations requires studies with larger sample sizes in the future. The difference between serum GDF15 and cerebrospinal fluid GDF15 should be considered.