Growth Differentiation Factor 15: A Novel Growth Biomarker for Children With Congenital Heart Disease

Dane C. Paneitz, Alice Zhou, Lisa Yanek, Srujana Golla, Sravani Avula, Prince J. Kannankeril, Allen D. Everett, Bret A. Mettler, Danielle Gottlieb Sen

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Failure to thrive (FTT), defined as weight or height less than the lowest 2.5 percentile for age, is prevalent in up to 66% of children with congenital heart disease (CHD). Risk stratification methods to identify those who would benefit from early intervention are currently lacking. We aimed to identify a novel growth biomarker to aid clinical decision-making in children with CHD. Methods: This is a cross-sectional study of patients 2 months to 10 years of age with any CHD undergoing cardiac surgery. Preoperative weight-for-age Z scores (WAZ) and height-for-age Z scores (HAZ) were calculated and assessed for association with preoperative plasma biomarkers: growth differentiation factor 15 (GDF-15), fibroblast growth factor 21, leptin, prealbumin, and C-reactive protein (CRP). Results: Of the 238 patients included, approximately 70% of patients had WAZ/HAZ < 0 and 34% had FTT. There was a moderate correlation between GDF-15 and WAZ/HAZ. When stratified by age, the correlation of GDF-15 to WAZ and HAZ was strongest in children under 2 years of age and persisted in the setting of inflammation (CRP > 0.5 mg/dL). Diagnoses commonly associated with congestive heart failure had high proportions of FTT and median GDF-15 levels. Prealbumin was not correlated with WAZ or HAZ. Conclusions: GDF-15 represents an important growth biomarker in children with CHD, especially those under 2 years of age who have diagnoses commonly associated with CHF. Our data do not support prealbumin as a long-term growth biomarker.

Original languageEnglish (US)
Pages (from-to)745-751
Number of pages7
JournalWorld Journal for Pediatric and Congenital Heart Surgery
Volume13
Issue number6
DOIs
StatePublished - Nov 2022
Externally publishedYes

Keywords

  • cytokines
  • metabolism
  • nutrition

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

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