Correlation Between Circulating Growth Differentiation Factor-11 And Carotid Atherosclerosis

Objective: Growth differentiation factor 11(Gdf11)is a member of TGF-βsuperfamily,which has the functions of anti-aging,reversing aged myocardial hypertrophy and skeletal muscle dysfunction,remodeling cerebral vessels and promoting olfactory neurogenesis in aged mice.Recent studies have shown that there is a close relationship between Gdf11 and lipid metabolism,oxidative stress response,expression of inflammatory factors,endothelial cell injury,aging and other factors involved in the formation of atherosclerotic plaque,but there is no report on the relationship between serum Gdf11 level and carotid atherosclerosis,Therefore,the purpose of this study is to explore whether there is a certain relationship between Gdf11 and CAS,and whether Gdf11 can inhibit the formation of atherosclerotic plaque,so as to delay or reverse the occurrence and development of the disease.Methods: A total of 161 subjects were included in this study.All participants underwent neck color Doppler ultrasound and coronary angiography.According to whether there was plaque formation in carotid artery,they were divided into CAS group(101 persons)and N-CASgroup(60 persons).In CAS group,they were divided into three subgroups according to the number of vascular lesions: A(single vascular lesion),B(double vascular lesion)and C(multiple vascular lesion).The diagnosis of CAS is based on the results of color Doppler ultrasound in our hospital.Serum Gdf11 levels of all participants were measured by enzyme linked immunosorbent assay(ELISA),and were used to compare whether there was any difference between CAS group and N-CAS group,and whether there was any association.The ROC characteristic curve was used to analyze serum Gdf11 to predict the risk of CAS,and the area under the curve(AUC),sensitivity,specificity and diagnostic threshold were calculated.Univariate and multivariate binary logistic regression were used to analyze whether serum Gdf11 was an independent protective factor of CAS.In CAS subgroup,the correlation between serum Gdf11 level and the number of carotid artery lesions was analyzed by non parametric Kruskal Wallis test..Results: The median and interquartile interval(IQR)of serum Gdf11 in CAS group and N-CAS group were 109.10(iqr63.67)pg / ml and 135.80(iqr76.54)pg / ml respectively,and there was significant difference between the two groups(P < 0.01).ROC characteristic curve showed that the critical value of Gdf11 in predicting CAS was 160.8915pg/ml,The sensitivity was 93.3%,specificity was 36.8%,area under the curve(AUC: 0.705),95% confidence interval(CI: 0.623-0.788).Multivariate logistic regression analysis showed that serum Gdf11 level was an independent protective factor of CAS patients,with regression coefficient =-0.21.In the three subgroups of CAS,Kruskal Wallis test showed that P = 0.114 > 0.05,There was no significant difference in Gdf11 level among the three CAS subgroups.Conclusion: The level of serum Gdf11 in N-CAS group was higher than that in CAS group.Gdf11 may inhibit the formation of atherosclerotic plaque,and serum Gdf11 may play an important role as a protective factor;Gdf11 level was not related to the number of carotid artery lesions.