Abstract
Growth-differentiation factor 15 (GDF15) is an inflammatory cytokine
involved in energy homeostasis. Its circulating levels are acutely
increased by the type 2 diabetes medication metformin, resulting in
reduced appetite and weight loss. We identified a genetic variant at the
GDF15 gene to proxy a small, lifelong increase in circulating GDF15
levels, and leveraged it in colocalization and Mendelian randomization
analyses to investigate the effects of chronically elevated GDF15 levels
on body mass index (BMI) and type 2 diabetes liability. The results
provide human genetic evidence supporting that chronically elevated
GDF15 levels increase BMI. There was no genetic evidence to support
bi-directional effects, or that chronically elevated GDF15 levels
directly affect liability to type 2 diabetes. Our results contrast the
BMI lowering effects of an acute increase in GDF15 levels observed after
metformin use. These findings have direct implications for informing
pharmacological strategies aimed at targeting GDF15 levels for weight
loss.