Association between GDF-15 and sarcopenia progression in older adults: results from a population-based study

Background: Growth differentiation factor-15 (GDF-15), a stress-induced cytokine, has been implicated in pathways related to muscle degeneration, although findings regarding its association with sarcopenia remain heterogeneous. This study investigated the association between serum levels of GDF-15 and sarcopenia progression in community-dwelling older adults. Methods: 2347 individuals (mean age 72.3 years [SD 10.4]; 61.6% women), participating in the Swedish National Study on Aging and Care in Kungsholmen, were included in the study. Sarcopenia status (no, probable, and confirmed sarcopenia) were defined according to modified European Working Group on Sarcopenia in Older People 2 criteria. Twelve-year longitudinal sarcopenia trajectories were identified through latent class analysis. GDF-15 was measured in serum samples collected at baseline. Logistic regression was employed to assess the associations between GDF-15 and sarcopenia progression. Findings: Two trajectories of sarcopenia were identified: an early-progression pattern around the age of 70 and a later-progression pattern around the age of 80. Baseline sarcopenia prevalence differed between trajectories (p < 0.001), and GDF-15 levels were higher in the early trajectory (1.00 ng/mL vs. 0.86 ng/mL, p < 0.001). In adjusted multinomial logistic models, higher GDF-15 was associated with greater odds of probable (aOR = 1.6; 95% CI: 1.2-2.0) and confirmed sarcopenia (aOR = 1.9; 95% CI: 1.3-2.6). GDF-15 levels were also linked to increased odds of belonging to the early progression trajectory (aOR = 1.5; 95% CI: 1.2-1.9), with the association driven by the highest quintiles. Interpretation: GDF-15 reflects biological processes linked to muscle degeneration and may provide complementary information alongside established measures of sarcopenia in community-dwelling older adults. Funding: The Swedish Research Council, the Swedish Ministry of Health and Social Affairs, and the County Councils and Municipalities.