Growth differentiation factor 15 (GDF15) has been associated with many important biological functions, such as food intake and weight regulation in response to metabolic stress. In animal models, it has also been noted that it may play a role in the progression of nonalcoholic fatty liver disease (NAFLD), the leading cause of chronic liver disease in children. Nevertheless, the exact role of GDF15 in liver disease has yet to be elucidated. We aimed to explore the association of GDF15 with NAFLD in obese youth, and whether GDF15 changes similarly with changes in hepatic fat content (HFF%) over time. Fasting plasma GDF15 levels were measured by ELISA in obese youth with (89) and without (95) NAFLD. Additionally, fasting GDF15 levels were measured in 22 obese youth who progressed (11) or regressed (11) in HFF% by more than 30% over a two-year period. Abdominal MRI was performed on all subjects to quantify HFF%. For the first time, we describe a novel association between GDF15 and NAFLD in obese youth. Figure 1A shows a statistically significant difference in fasting GDF15 levels (p<0.0001) between three groups stratified by degree of HFF%. Figure 1B shows a statistically significant association between change in HFF% and change in GDF15 (p=0.01; r2=0.29). These data suggest that GDF15 levels change with change in intrahepatic fat content in obese youth and may serve as a biomarker for NAFLD in children.


B. Galuppo: None. C. Agazzi: None. B. Pierpont: None. S. Samuels: None. E. Tarabra: None. S. Caprio: None. N. Santoro: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at