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

Q: What are the key findings of this study?

GDF-15 was significantly elevated in Moyamoya disease vs controls (701.31 vs 371.22 pg/mL, p<0.0001; OR 1.004, 95% CI 1.003-1.006) with the highest diagnostic AUC of 0.779.

Q: What is the clinical evidence from this study?

Study design: Case-Control. Population: Moyamoya disease (n=265). Intervention: Growth differentiation factor-15 (GDF-15) and inflammatory/cardiac-stress biomarkers vs. Healthy age- and sex-matched control subjects. Primary outcome: Presence of Moyamoya disease (associated with serum GDF-15 levels) (OR 1.004, 95% CI 1.003-1.006, p=<0.0001).

Q: What does this research mean for the field?

Serum GDF-15 levels are significantly elevated in patients with Moyamoya disease compared to healthy controls and serve as an independent diagnostic biomarker. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To compare clinical, inflammatory, and cardiac-stress biomarkers between patients with Moyamoya disease and healthy controls, while assessing the diagnostic utility and risk associations of GDF-15.

Fengxia Guo; Hanxiao Li; Qiushi Guo; Yumeng Wang; Xiaohuan Zhang; Weiguang Luo

doi:10.3389/fnagi.2026.1906016

October 12, 2026Frontiers in Aging NeuroscienceOpen Access

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

View Full Paper

Ask AI

Bookmark

Share

Key result

Elevated serum GDF-15 is independently linked to Moyamoya disease.

OR 1.004
95% CI 1.003-1.006
P<0.0001
n=265

Figures

Why the study?

Moyamoya disease is an uncommon cerebrovascular condition that requires the identification of easily measurable biomarkers, including GDF-15 and inflammatory and cardiac-stress markers, to enable prompt diagnosis.

Does serum GDF-15 and related inflammatory or cardiac-stress biomarkers differentiate patients with newly diagnosed asymptomatic Moyamoya disease from healthy controls?

Key Points

To compare clinical, inflammatory, and cardiac-stress biomarkers between patients with Moyamoya disease and healthy controls, while assessing the diagnostic utility and risk associations of GDF-15.
Enrolled a study cohort of 265 participants, consisting of 121 patients diagnosed with Moyamoya disease and 144 healthy control subjects.
Quantified circulating biomarkers including white blood cell count (WBC), neutrophil count (NEU), glucose (Glu), homocysteine (HCY), soluble ST-2, and GDF-15.
Evaluated biomarker relationships and predictive capacity using correlation assessments, receiver operating characteristic (ROC) curves, and multivariable logistic regression.
Patients with MMD had significantly higher GDF-15 (701.31 ± 37.42 pg/mL vs 371.22 ± 19.16 pg/mL, p < 0.0001) and soluble ST-2 (11.16 ± 1.14 ng/mL vs 7.55 ± 1.35 ng/mL, p = 0.0063) than controls, with GDF-15 correlating with WBC (r = 0.53, p < 0.0001) and NEU (r = 0.45, p = 0.026).
ROC analysis demonstrated that GDF-15 had the highest diagnostic performance with an AUC of 0.779 (95% CI: 0.723–0.834, p < 0.0001; 75.21% sensitivity and 75.00% specificity at 405 pg./mL), outperforming NEU (AUC 0.668), Glu (AUC 0.590), and WBC (AUC 0.577).
Multivariable logistic regression confirmed GDF-15 (OR 1.004, 95% CI: 1.003–1.006, p < 0.0001; ~49% higher odds per 100 pg./mL increment), NEU (OR 1.85, 95% CI: 1.45–2.44, p < 0.0001), and diabetes (OR 2.86, 95% CI: 1.55–5.42, p = 0.0009) as independent risk factors for MMD.

Study Design

Type

Case-Control (n=265)

Multicenter

No

Structured PICO

Does serum GDF-15 and related inflammatory or cardiac-stress biomarkers differentiate patients with newly diagnosed asymptomatic Moyamoya disease from healthy controls?

P

Population

265 adult participants (121 newly diagnosed, asymptomatic Moyamoya disease patients within 6 months of diagnosis and 144 age- and sex-matched healthy controls) in a single-center case-control study.

E

Exposure

Serum levels of growth differentiation factor-15 (GDF-15), soluble ST-2, white blood cell count (WBC), neutrophil count (NEU), homocysteine (HCY), and glucose (Glu) measured at diagnosis prior to anticoagulant or antiplatelet therapy.

C

Comparator

Age- and sex-matched healthy control subjects undergoing routine health check-ups during the same period (n=144).

O

Outcome

Diagnostic discrimination and multivariable independent risk association with Moyamoya disease (MMD) diagnosis.surrogate

Main Result

Odds Ratio: 1.004 (95% CI 1.003–1.006)

Absolute Event Rate: 701.31% vs 371.22%

p-value: p=<0.0001

Serum GDF-15 and neutrophil counts are independently elevated in newly diagnosed asymptomatic Moyamoya disease, with GDF-15 showing potential utility as a non-invasive adjunctive diagnostic biomarker (AUC 0.779).

Limitations

Relatively small sample size sourced from a single center without an independent external validation cohort.
Cross-sectional case-control design precludes causal inferences and assessment of association with disease severity or progression.
Lack of patient stratification according to clinical subtype (ischemic vs hemorrhagic) or disease stage (Suzuki grade).
Cohort restricted to newly diagnosed, asymptomatic MMD patients without prior cerebrovascular events, limiting generalizability.
Relatively small sample size from a single center lacking an independent external validation cohort
Cross-sectional case-control design precludes causal inference and evaluation of disease progression
Patients were not stratified by clinical subtype (ischemic vs hemorrhagic) or Suzuki disease grade
Inclusion criteria restricted to newly diagnosed asymptomatic patients without prior stroke/TIA, limiting generalizability to all MMD patients

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

GDF-15 may support adjunctive diagnosis in Moyamoya disease; hypothesis-generating and requires prospective validation before clinical use.

Abstract

Background 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. Methods 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. Results 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. Conclusion 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.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Guo et al. (2026) conducted a case-control in Moyamoya disease (n=265). Growth differentiation factor-15 (GDF-15) and inflammatory/cardiac-stress biomarkers vs. Healthy age- and sex-matched control subjects was evaluated on Presence of Moyamoya disease (associated with serum GDF-15 levels) (OR 1.004, 95% CI 1.003-1.006, p=<0.0001). GDF-15 was significantly elevated in Moyamoya disease vs controls (701.31 vs 371.22 pg/mL, p<0.0001; OR 1.004, 95% CI 1.003-1.006) with the highest diagnostic AUC of 0.779.

synapsesocial.com/papers/6aee6b6871a759480622092b https://doi.org/10.3389/fnagi.2026.1906016

View Full Paper

Ask AI

Bookmark

Share

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

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading