Inflammatory and cardiac-stress biomarkers in Moyamoya disease: the role of GDF-15

Abstract

Moyamoya disease (MMD) is an uncommon cerebrovascular condition that requires the identification of easily measurable biomarkers to enable prompt diagnosis. This study aimed to: (1) compare clinical and laboratory parameters between individuals with MMD and control subjects; (2) examine the associations of these parameters with growth differentiation factor-15 (GDF-15); (3) evaluate the diagnostic effectiveness of potential biomarkers; and (4) identify independent risk factors for MMD. The study cohort comprised 265 participants, including 121 patients diagnosed with MMD and 144 healthy control subjects. The parameters measured included white blood cell count (WBC), neutrophil count (NEU), Glu, homocysteine (HCY), GDF-15, and soluble growth stimulation expressed gene 2 (ST-2) concentrations. The analyses conducted encompassed correlation assessments, receiver operating characteristic (ROC) curve evaluations, and multivariable logistic regression analyses. Baseline characteristics were comparable between groups except for smoking status, which was significantly more frequent in the MMD group ( p  = 0.046). Patients diagnosed with MMD exhibited significantly elevated levels of WBC, NEU, HCY, GDF-15 and soluble ST-2. No significant differences were observed in Glu levels ( p  = 0.468). GDF-15 demonstrated a positive correlation with WBC ( r  = 0.53, p  < 0.0001), NEU ( r  = 0.45, p  = 0.026), but not with Glu or HCY ( p  > 0.05). ROC analysis revealed that GDF-15 had the highest area under the curve (AUC) (0.779), followed by NEU (0.668), Glu (0.590), and WBC (0.577). Multivariable logistic regression analysis identified Diabetes, NEU, and GDF-15 as independent risk factors (all p  < 0.001). A 100 pg./mL increment in GDF-15 levels was correlated with an estimated 49% elevation in the odds of MMD occurrence. Patients diagnosed with MMD exhibit a unique profile of inflammatory and cardiac-stress biomarkers. GDF-15 and NEU were independently correlated with MMD. Among these, GDF-15 demonstrated the highest diagnostic efficacy, suggesting its potential utility as a non-invasive adjunctive biomarker.