EP 172 Tracking Inflammation Over Time: Longitudinal Dynamics of CRP and GDF-15 With Implications for Cachexia Management
Chattarin Pumtako, Donald McMillan, Barry Laird, Ross Dolan, John Wadsworth, Donogh MaguireAbstract
Background
C-reactive protein (CRP) is a well-established marker of systemic inflammation, while Growth Differentiation Factor-15 (GDF-15) has emerged as a potential biomarker of chronic stress and cachexia. Their relative perioperative dynamics remain incompletely defined.
Methods
This prospective observational study included 47 patients undergoing elective knee arthroplasty. After excluding nine patients with elevated baseline CRP (>10 mg/L), serial measurements of CRP and GDF-15 were analysed daily in 38 patients from pre-operation to postoperative Days 1–3.
Results
CRP rose sharply after surgery, peaking on Day 3 with an increase exceeding 6,800% from baseline. GDF-15 levels also increased significantly, but more modestly (74% increase), with a sustained upward trajectory. CRP and GDF-15 were significantly correlated on postoperative Day 1 (rs = 0.53, p = 0.001) but not days 2 and 3. Baseline GDF-15, but not CRP, was significantly associated with oral hypoglycaemic agent use and vitamin B12 supplementation. Compared to values reported in recent randomized trials of ghrelin, anti-GDF-15, and anti-IL-6 therapies, GDF-15 levels in this surgical cohort remained lower, while CRP approached levels observed in such studies.
Conclusion
CRP and GDF-15 rise in parallel following surgical injury; however, GDF-15 shows a considerably lower sensitivity to the inflammatory response. These findings may suggest a complementary role of GDF-15 alongside CRP in characterizing systemic stress and inflammation, although its relatively modest response limits its utility as a primary marker of acute surgical inflammation.