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Growth differentiation factor-15 as a biomarker of strength and recovery in survivors of acute respiratory failure
  1. Brian J Rosenberg1,
  2. Michio Hirano2,
  3. Catarina M Quinzii2,
  4. Elizabeth Colantuoni3,4,
  5. Dale M Needham3,5,
  6. David J Lederer1,
  7. Matthew R Baldwin1
  1. 1 Department of Medicine, Division of Pulmonary, Allergy, and Critical Care, Columbia University, New York, New York, USA
  2. 2 Department of Neurology, Division of Neuromuscular Disorders, Columbia University, New York, NY, United States
  3. 3 Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, Maryland, USA
  4. 4 Department of Biostatistics, Johns Hopkins University – Bloomberg School of Public Health, Baltimore, Maryland, USA
  5. 5 Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Dr Matthew R Baldwin,Medicine, Columbia University, New York, New York, USA; mrb45{at}


Muscle mitochondrial dysfunction is implicated in intensive care unit-acquired weakness, but there is no serum biomarker of muscle mitochondrial function for critical illness survivors. Higher serum growth differentiation factor-15 (GDF-15) is a biomarker of inherited mitochondrial myopathy disease and is associated with mortality in several age-related diseases. Among 142 older (age ≥ 65 years) survivors of acute respiratory failure, we found that higher serum GDF-15 measured during the week prior to hospital discharge was cross-sectionally associated with weaker diaphragm, limb and hand-grip strength, and longitudinally associated with lower rates of functional recovery over 6 months, independent of age, sex, pre-existing disability, comorbidity, frailty, Acute Physiology and Chronic Health Evaluation II scores and concurrent interleukin-6 levels.

  • Critical Care
  • Pulmonary Rehabilitation
  • Not Applicable

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  • Contributors Study design and concept: MRB and MH; acquisition, analysis or interpretation of data: BJR, DJL, MRB, EC and DMN; drafting of the manuscript: BJR and MRB; critical revision of the manuscript: all authors. Statistical analysis: BJR, MRB, EC and DJL. Study supervision: MRB. Dr Rosenberg and Dr Baldwin had full access to all of the data in the study and take responsibility of the integrity of the data and accuracy of the data analysis.

  • Funding Dr Baldwin is supported by NIH grant K23 AG045660, a faculty research fellowship from the Columbia University Aging Center, and the Columbia University Irving Institute (NIH grant UL1 TR001873). Dr Quinzii and Dr Hirano are supported by NIH grant P01 HD080642. Dr Hirano is also supported by NIH grant U54 NS078059. Dr Lederer is supported by NIH grants R01 HL103676, R01 HL137234 and K24 HL131937.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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