Factors associated with serum GDF-15, iron deficiency and lower hemoglobin levels in patients with chronic heart failure and healthy elderly people

Background Coexistent chronic heart failure and iron deficiency is frequently encountered in clinical practice and affects prognosis. We investigated factors associated with serum growth differentiation factor (GDF)-15, iron deficiency and lower hemoglobin levels in patients with heart failure and healthy elderly individuals. Methods and results Blood tests were performed on 90 patients with heart failure (aged 75.0 ± 10.7 years) and 73 healthy elderly individuals (aged 76.3 ± 6.4 years). Serum GDF-15, tumor necrosis factor (TNF) α, N-terminal pro-brain natriuretic peptide (NT-proBNP), and hepcidin concentrations were measured using enzyme-linked immunosorbent assay. Left atrial volume index (LAVI) was measured by echocardiography. Hemoglobin (Hb) in healthy elderly individuals correlated with serum iron and hepcidin. In contrast, Hb in patients with heart failure correlated with serum iron and GDF-15. Serum GDF-15 concentration in healthy elderly subjects correlated with estimated glomerular filtration rate, serum iron, and hepcidin. In contrast, in patients with heart failure, it correlated with NT-proBNP and TNFα. In patients with heart failure, serum iron correlated with LAVI. Conclusions Lower hemoglobin levels in patients with heart failure might be associated with elevated serum GDF-15 due to higher serum NT-proBNP and inflammation, as well as iron deficiency. In contrast, lower hemoglobin levels in healthy elderly individuals might involve lower serum iron and hepcidin levels. Lower serum iron concentration was suggested to be involved in left atrial remodeling in patients with heart failure.