Open AccessAssociation between Growth Differentiation Factor 15 and Non-Dipping Circadian Pattern in Patients with Newly Diagnosed Essential Hypertension
Author(s) -
Sökmen Erdoğan,
Uçar Cahit,
Sivri Serkan,
Çelik Mustafa,
Boduroğlu Yalçın,
Erer Murat,
Yıldırım Alp,
İlanbey Bilal
Publication year - 2019
Publication title -
medical principles and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 45
eISSN - 1423-0151
pISSN - 1011-7571
DOI - 10.1159/000501096
Subject(s) - original paper
Objective: Non-dipper hypertension (HT) confers greater risk compared with dipper HT. Growth differentiation factor 15 (GDF-15) recently emerged as a novel and independent marker of cardiovascular disease, both in diagnostic and prognostic scopes. Our aim was to evaluate the relationship of circadian blood pressure (BP) pattern with serum GDF-15 level in newly diagnosed HT patients without left ventricular hypertrophy. Subjects and Methods: Newly diagnosed non-dipper ( n = 66) and dipper ( n = 60) HT patients were selected according to 24-h ambulatory BP monitoring (ABPM). The controls comprised healthy normotensive subjects ( n = 31). Data was collected through physical examination, laboratory analysis, ABPM, and echocardiography. GDF-15 was measured using ELISA. Results: Greater GDF-15 level was found in the non-dippers compared with the dippers and the controls (557.53 ± 91.7, 513.79 ± 62.86, and 494.44 ± 79.30 ng/L, respectively, p < 0.001). In bivariate linear correlation analysis, GDF-15 correlated positively with glomerular filtration rate ( r = 0.180, p = 0.030), total cholesterol ( r = 0.170, p = 0.038), septal E/E′ ratio ( r = 0.344, p = 0.001), lateral E/E′ ratio ( r = 0.366, p < 0.001), nighttime systolic BP ( r = 0.166, p = 0.046), and nighttime diastolic BP ( r = 0.188, p = 0.024); however, it correlated negatively with septal and lateral E′ velocities ( r = 0.268, p = 0.005 and r = 0.236, p = 0.013, respectively). Furthermore, GDF-15 level and nighttime diastolic BP remained independently associated with non-dipper HT. In ROC analysis, optimal cutoff value for GDF-15 was 524.6 ng/L with 56.7% sensitivity and 72.4% specificity (AUC: 0.676, 95% CI: 0.580–0.772, p < 0.05). Conclusion: Our results showed GDF-15 upregulation in the non-dipper HT group. GDF-15 and nighttime diastolic BP were independently associated with the non-dipping pattern. This study may suggest possible utilization of GDF-15 in the prediction of non-dipper HT.