# Association of elevated circulating GDF15 and risk in acute retinal artery occlusion

## TL;DR

High levels of GDF15 in the blood are linked to an increased risk of acute retinal artery occlusion and could help diagnose the condition.

## Contribution

This study identifies GDF15 as a novel biomarker for diagnosing retinal artery occlusion and improves diagnostic accuracy when combined with other parameters.

## Key findings

- GDF15 levels were significantly higher in RAO patients compared to controls in both serum and aqueous humor.
- A multiparameter model including GDF15 achieved high diagnostic accuracy (AUC = 0.92) for RAO.
- GDF15 was identified as an independent risk factor for RAO alongside triglycerides and glucose.

## Abstract

We aimed to investigate the association between circulating growth differentiation factor-15 (GDF15) levels and retinal artery occlusion (RAO), and to assess the diagnostic performance of GDF15 for discriminating RAO patients from controls.

In this cross-sectional study, we quantified serum GDF15 levels using enzyme-linked immunosorbent assay (ELISA). After performing propensity score matching with age and sex adjustment, we conducted univariate and multivariate analyses to describe RAO risk factors. Subsequently, multivariable logistic regression combined with restricted cubic spline analysis was performed to assess the significance of GDF15 in RAO risk evaluation.

The results showed that GDF15 levels in patient was significantly increased in serum (median: 587.89 pg./mL vs. 331.54 pg./mL, p < 0.001) and aqueous humor (median: 442.8 pg./mL vs. 81.21 pg./mL, p < 0.01) of patients. Univariate and multivariate analyses identified triglyceride (TG), glucose (Glu), and GDF15 as independent risk factors for RAO. Multivariable linear regression analysis revealed that TG and Glu were positively correlated with GDF15 levels, whereas estimated glomerular filtration rate (eGFR) and triglyceride–Glu (TyG) were inversely correlated. The multiparameter combination (GDF15, TyG index, Glu, TG, neutrophil) demonstrated superior diagnostic performance for RAO (area under the curve, AUC = 0.92) compared with individual biomarkers, each of which showed moderate discriminative ability.

Our findings indicate that elevated GDF15 levels are significantly associated with the incidence of RAO. GDF15 exhibited acceptable diagnostic accuracy as a single marker, and the inclusion of GDF15 in a multiparameter diagnostic model significantly improved discrimination, highlighting its potential as a biomarker for RAO.