GDF15 and chronic obstructive pulmonary disease: GDF-15 is a stress-induced protein, produced by a variety of cells under stress conditions including tissue injury, anoxia, and inflammation (28). Elevated circulating GDF-15 levels have been associated with more severe disease or higher mortality in people with DM2, insulin resistance, hemodialysis, cachexia, cardiovascular diseases, chronic obstructive pulmonary disease (COPD), venous thromboembolism (VTE), cancer, or obesity (28–34).