BACKGROUND: Growth differentiation factor 15 (GDF-15) levels are emerging as a candidate biomarker of aging. The present study aimed to: (1) characterize the association of GDF-15 with the continuum of arterial stiffening, assessed as carotid-femoral pulse wave velocity, as age increases
(2) determine the predictive role of serum GDF-15 levels on mortality
and (3) identify genetic determinants of serum GDF-15 levels. METHODS AND RESULTS: Serum levels of GDF-15 and established cardiovascular risk factors, including pulse wave velocity, were assessed in a large (4736 individual) Sardinian population. Serum levels of GDF-15, which can be reliably measured repeatedly over time, increase with age
are associated with a stiffer aorta
"mediate" a large proportion of the age-associated increase in arterial stiffness
pose risks because of their association with greater mortality
and are significantly associated with the variant rs11549407, which causes thalassemia major in homozygosity. CONCLUSIONS: Because of its consistent ability to predict functional and clinical outcomes, including all-cause mortality, we conclude that GDF-15 serum levels serve as a robust biomarker for the continuum from health to the emergence of clinical disease during aging and, subsequently, to the likelihood of mortality.