Nephrology Department, Centro Hospitalar Universitário do Algarve, 800-836 Faro, Portugal.
Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, 8005-139 Faro, Portugal.
Int J Mol Sci. 2019 Mar 27;20(7):1536. doi: 10.3390/ijms20071536.
Research over the past decade has focused on the role of Klotho as a cardio protective agent that prevents the effects of aging on the heart and reduces the burden of cardiovascular disease CVD. The role of the interaction between fibroblast growth factor 23-(FGF-23)/Klotho in Klotho-mediated actions is still under debate. The main objective was to ascertain the potential use of plasmatic Klotho and FGF23 as markers for CKD-associated cardiac disease and mortality.
This was a prospective analysis conducted in an outpatient diabetic nephropathy clinic, enrolling 107 diabetic patients with stage 2⁻3 CKD. Patients were divided into three groups according to their left ventricular mass index and relative wall thickness.
Multinomial regression analysis demonstrated that low Klotho and higher FGF-23 levels were linked to a greater risk of concentric hypertrophy. In the generalized linear model (GLM), Klotho, FGF-23 and cardiac geometry groups were statistically significant as independent variables of cardiovascular hospitalization ( = 0.007). According to the Cox regression model, fatal cardiovascular events were associated with the following cardiac geometric classifications; eccentric hypertrophy ( = 0.050); concentric hypertrophy ( = 0.041), and serum phosphate ≥ 3.6 mg/dL ( = 0.025), FGF-23 ≥ 168 ( = 0.0149), α-klotho < 313 ( = 0.044).
In our population, Klotho and FGF23 are associated with cardiovascular risk in the early stages of CKD.
过去十年的研究重点是 Klotho 作为一种心脏保护剂的作用，它可以防止衰老对心脏的影响，降低心血管疾病（CVD）的负担。成纤维细胞生长因子 23（FGF-23）/Klotho 之间相互作用在 Klotho 介导的作用中的作用仍存在争议。主要目的是确定血浆 Klotho 和 FGF23 作为 CKD 相关心脏疾病和死亡率的标志物的潜在用途。
这是一项在门诊糖尿病肾病诊所进行的前瞻性分析，共纳入 107 例 2⁻3 期 CKD 的糖尿病患者。根据左心室质量指数和相对壁厚度将患者分为三组。
多项回归分析表明，Klotho 水平低和 FGF-23 水平高与向心性肥厚的风险增加相关。在广义线性模型（GLM）中，Klotho、FGF-23 和心脏几何组作为心血管住院的独立变量具有统计学意义（ = 0.007）。根据 Cox 回归模型，致命心血管事件与以下心脏几何分类相关；离心性肥厚（ = 0.050）；向心性肥厚（ = 0.041）和血清磷酸盐≥3.6mg/dL（ = 0.025），FGF-23≥168（ = 0.0149），α-Klotho<313（ = 0.044）。
在我们的人群中，Klotho 和 FGF23 与 CKD 早期的心血管风险相关。
