GDF-15/MIC-1 is synthesized as a 62-kDa precursor protein, which, after cleavage by furin-like protease, is secreted as 25-kDa disulfide-linked dimmer. GDF-15/MIC-1 is weakly produced under baseline condition in most tissues such as brain, liver, kidney, pancreas, but not normally in many other organs including the heart, and is highly expressed in placenta and moderately in prostate. GDF-15 is upregulated by cardiovascular events triggering oxidative stress, including pressure overload, and atherosclerosis. Moreover, increased circulating GDF-15 concentrations have been linked to an enhanced risk of future adverse cardiovascular events in elderly woman and it was describe as a new biomarker of the risk of death in patients with non-ST-elevation acute coronary syndrome. Serum GDF-15 concentrations increase in maternal serum with advancing gestation in normal pregnancy. Low GDF-15 concentrations reportedly are associated with an increased risk of preterm labor or miscarriage.
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