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Association between GDF15, poverty and mortality in urban middle-aged African American and white adults

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  • David W Freeman
  • Nicole Noren Hooten
  • Yoonseo Kim
  • Nicolle A Mode
  • Ngozi Ejiogu
  • Alan B Zonderman
  • Michele K Evans

Abstract

Mortality disparities are influenced by race and poverty. There is limited information about whether poverty influences biologic markers of mortality risk. Emerging data suggests that growth differentiation factor 15 (GDF15) is associated with mortality; however, the interplay between GDF15, sociodemographic factors and mortality is not known. We sought to evaluate the interactions between GDF15 and sex, race and poverty status on mortality. Serum GDF15 was measured in 1036 African American and white middle-aged men and women above and below 125% of the Federal poverty status from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Multivariable adjusted Cox regression models were used to assess the association between log-transformed GDF15 (logGDF15) and 12-year mortality outcomes (all-cause, cardiovascular- and cancer-specific outcomes) and interactions with sex, race and poverty status. Likelihood ratio tests were used to assess significance of the interaction terms. Median GDF15 was 655.2 pg/mL (IQR = 575.1). During 12.2 years of follow-up, 331 died of which 94 cardiovascular- and 87 were cancer-specific deaths. One unit of increase in logGDF15 was associated with a hazard ratio for all-cause mortality, cardiovascular- and cancer-specific mortality of 2.26 (95% confidence interval [CI], 1.94–2.64), 2.74 (95%CI, 2.06–3.63) and 1.41 (95%CI, 1.00–2.00), respectively. There was an interaction between logGDF15 and poverty status on all-cause mortality (p

Suggested Citation

  • David W Freeman & Nicole Noren Hooten & Yoonseo Kim & Nicolle A Mode & Ngozi Ejiogu & Alan B Zonderman & Michele K Evans, 2020. "Association between GDF15, poverty and mortality in urban middle-aged African American and white adults," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-13, August.
    • Handle: RePEc:plo:pone00:0237059
    DOI: 10.1371/journal.pone.0237059
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    1. Needham, Belinda L. & Adler, Nancy & Gregorich, Steven & Rehkopf, David & Lin, Jue & Blackburn, Elizabeth H. & Epel, Elissa S., 2013. "Socioeconomic status, health behavior, and leukocyte telomere length in the National Health and Nutrition Examination Survey, 1999–2002," Social Science & Medicine, Elsevier, vol. 85(C), pages 1-8.
    2. Colen, Cynthia G. & Ramey, David M. & Cooksey, Elizabeth C. & Williams, David R., 2018. "Racial disparities in health among nonpoor African Americans and Hispanics: The role of acute and chronic discrimination," Social Science & Medicine, Elsevier, vol. 199(C), pages 167-180.
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