Kim Hyo Jin, Kang Eunjeong, Oh Yun Kyu, Kim Yeong Hoon, Han Seung Hyeok, Yoo Tae Hyun, Chae Dong-Wan, Lee Joongyub, Ahn Curie, Oh Kook-Hwan
Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju-si, Gyeongsangbuk-do, South Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
BMC Nephrol. 2018 Mar 5;19(1):51. doi: 10.1186/s12882-018-0851-3.
Klotho, a protein linked to aging, has emerged as a pivotal player in mineral bone metabolism and might explain the relationship between chronic kidney disease (CKD) and cardiovascular disease (CVD). The present study aimed to investigate the association between serum klotho and cardiac parameters from a large-scale Korean CKD cohort.
We analyzed 2101 participants from KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) cohort who had been measured for serum klotho levels. Left ventricular hypertrophy evaluated by left ventricular mass index (LVMI) and arterial stiffness measured by brachial-to-ankle pulse wave velocity (baPWV) were explored as cardiovascular parameters.
Patients were 53.6 ± 12.2 years old and 61.1% were male. The mean estimated glomerular filtration rate (eGFR) was 53.0 ± 30.7 mL/min/1.73m. The median serum klotho level was 536 (interquartile range [IQR]: 420-667) pg/mL. Advanced CKD stages were associated with lower serum klotho levels (P < 0.001, P for linear trend < 0.001). Ascending quartiles of klotho were significantly associated with decreased LMVI (P < 0.001, P for linear trend< 0.001). A multivariable linear regression model showed serum klotho had a significant inverse association with LVMI (β - 0.04; 95% CI [confidence interval] -0.004, - 0.00007; P = 0.041). However, there was no significant association between serum klotho and baPWV after adjustment (β 0.003; 95% CI -0.04, 0.05; P = 0.876).
This trial was registered on ClinicalTrials.gov on 28 June 2012 ( NCT01630486 ).
Serum klotho was an independent biomarker of LVMI, but not arterial stiffness.
klotho是一种与衰老相关的蛋白质，已成为矿物质骨代谢的关键因子，可能解释慢性肾脏病（CKD）与心血管疾病（CVD）之间的关系。本研究旨在探讨韩国大规模CKD队列中血清klotho与心脏参数之间的关联。
我们分析了来自韩国慢性肾脏病患者结局队列研究（KNOW-CKD）队列的2101名参与者，这些参与者的血清klotho水平已被测量。通过左心室质量指数（LVMI）评估的左心室肥厚和通过臂踝脉搏波速度（baPWV）测量的动脉僵硬度被作为心血管参数进行研究。
患者年龄为53.6±12.2岁，61.1%为男性。平均估计肾小球滤过率（eGFR）为53.0±30.7 mL/min/1.73m²。血清klotho水平中位数为536（四分位间距[IQR]：420 - 667）pg/mL。晚期CKD阶段与较低的血清klotho水平相关（P < 0.001，线性趋势P < 0.001）。klotho四分位数升高与LVMI降低显著相关（P < 0.001，线性趋势P < 0.001）。多变量线性回归模型显示血清klotho与LVMI呈显著负相关（β -0.04；95%置信区间[CI] -0.004，-0.00007；P = 0.041）。然而，调整后血清klotho与baPWV之间无显著关联（β 0.003；95% CI -0.04，0.05；P = 0.876）。
本试验于2012年6月28日在ClinicalTrials.gov注册（NCT01630486）。
血清klotho是LVMI的独立生物标志物，但不是动脉僵硬度的独立生物标志物。
