ArticleClinical rheumatology2026
Growth differentiation factor-15 as a potential biomarker in subclinical inflammation in familial mediterranean fever.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThis study aimed to investigate whether growth differentiation factor-15 (GDF-15) can serve as a potential biomarker for assessing subclinical inflammation during the attack-free (intercritical) period in patients with familial Mediterranean fever (FMF).
methodsIn a single-center cross-sectional case-control study, 52 FMF patients in the attack-free period were compared with 52 age- and sex-matched healthy controls. ELISA measured serum GDF-15 levels; acute-phase reactants (CRP, ESR, SAA, fibrinogen) and various hematologic inflammation indices were evaluated. Statistical analyses included the Mann-Whitney U, chi-square, Kruskal-Wallis, Spearman correlation, and ROC curve methods.
resultsSerum GDF-15 levels were significantly higher in the FMF group than in controls (p < 0.001). Subclinical inflammation, defined by SAA > 10 mg/L, was detected in 78.8% of FMF patients. GDF-15 correlated positively with CRP and SAA (p < 0.05). GDF-15 levels did not differ across MEFV mutation subgroups or by the presence of the M694V mutation. Patients with subclinical inflammation had significantly higher GDF-15 levels than those without. ROC analysis showed that GDF-15 had a statistically significant ability to distinguish FMF from controls (AUC = 0.78; p < 0.001) and to identify subclinical inflammation (AUC = 0.74; p = 0.014).
conclusionGDF-15 appears to be a potential biomarker reflecting ongoing subclinical inflammation during the attack-free period in FMF. Elevated GDF-15 levels in patients with SAA-defined subclinical inflammation suggest that GDF-15 may reflect low-grade inflammatory activity. Larger studies are needed to validate these findings. Key Points • Serum GDF-15 was significantly higher in the attack-free FMF patients than in controls, supporting its potential to reflect persistent low-grade (subclinical) inflammation. • GDF-15 showed moderate discriminative performance (AUC 0.783) and may complement conventional acute-phase reactants in assessing inflammatory burden during attack-free periods. • GDF-15 levels did not differ significantly across MEFV mutation subgroups or by M694V status in this cohort.
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