Growth differentiation factor-15 and body roundness index in relation to cardiometabolic risk in young adults with obesity.

PURPOSE: Cardiometabolic risk in young adults is often subclinical. This cross-sectional study evaluated Growth Differentiation Factor-15 (GDF-15) and Body Roundness Index (BRI) in relation to cardiometabolic risk in young adults. METHODS: Ninety adults aged 18-35 years were classified into control, low-risk, and high-risk groups using predefined criteria. Anthropometric, glycemic, and lipid parameters, hs-CRP, GDF-15, leptin, and adiponectin were analyzed using ANCOVA, partial correlation, regression, and ROC analysis. RESULTS: GDF-15 rose progressively across groups (control 337.7 ± 82.6, low-risk 865.8 ± 76.9, high-risk 1130.7 ± 79.2 pg/mL; p < 0.001). Leptin, the leptin-to-adiponectin ratio, and adiponectin were higher in both risk groups than controls (p < 0.001), with no difference between risk groups. GDF-15 showed high discriminatory ability for controls versus obese groups (AUC 0.939-0.954), reflecting phenotypic separation, but only modest discrimination between low-risk and high-risk groups (AUC = 0.677, 95% CI 0.535-0.819; p = 0.024), the clinically relevant comparison. In exploratory subgroup regression, adiponectin was associated with GDF-15 in low-risk (β = 0.465, p = 0.011) and high-risk groups (β = 0.551, p = 0.038). Combining GDF-15 with waist-to-hip ratio gave a numerically higher AUC (0.708), although the difference was not formally tested. CONCLUSION: GDF-15 levels increased progressively across the study groups and remained significantly different across groups after adjustment for age. GDF-15 and adiponectin showed very high discrimination between obese participants and controls but only modest discrimination between risk groups. These exploratory, cross-sectional findings identify GDF-15 as a candidate biomarker of cardiometabolic risk in young adults, requiring confirmation in larger prospective cohorts.