Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
J Cardiol. 2021 Jun;77(6):583-589. doi: 10.1016/j.jjcc.2020.11.014. Epub 2020 Dec 7.
Although the Klotho gene is recognized as an aging-suppressor gene, the clinical significance of its soluble product, soluble Klotho, in coronary artery disease (CAD) has not been completely determined. The relationship between soluble Klotho and coronary artery calcification (CAC) was investigated in patients with stable CAD.
CAC in culprit lesions was analyzed in 75 non-dialysis patients with stable CAD who were scheduled for percutaneous coronary intervention (PCI) following intravascular ultrasound (IVUS). The main outcome measure was the calcium index (CalcIndex), a volumetric IVUS-derived measure of total calcification per culprit lesion. A low CalcIndex was defined as a first-quartile calcium index (<0.042). Patients were divided into two groups according to the median serum Klotho value: low Klotho (n = 37, ≤460 pg/mL) and high Klotho (n = 38, >460 pg/mL).
The CalcIndex was significantly lower in patients with high than with low Klotho. Patients with high Klotho had a significantly higher prevalence of a low CalcIndex than those with low Klotho. The number of angiographic moderate-severe CACs in whole coronary arteries was significantly decreased in patients with high Klotho compared to low Klotho. Serum Klotho levels correlated significantly and inversely with the CalcIndex. This relationship was pronounced in patients with estimated glomerular filtration rate <60 mL/min/1.73 m. Logistic regression analysis showed that high Klotho was associated with a low CalcIndex independent of classical coronary risk factors and markers of mineral metabolism.
High serum soluble Klotho levels are associated with a low degree of CAC in non-dialysis, stable CAD patients treated by PCI.
Klotho 基因被认为是衰老抑制基因，但可溶性 Klotho （sKlotho）作为其可溶性产物，其在冠状动脉疾病（CAD）中的临床意义尚未完全确定。本研究旨在探讨稳定型 CAD 患者中可溶性 Klotho 与冠状动脉钙化（CAC）的关系。
对 75 例行经皮冠状动脉介入治疗（PCI）的稳定型 CAD 患者进行血管内超声（IVUS）分析罪犯病变 CAC。主要观察指标为钙指数（CalcIndex），这是一种基于 IVUS 的容积测量方法，用于测量每个罪犯病变的总钙化量。低 CalcIndex 定义为 CalcIndex 四分位数的第一分位数（<0.042）。根据血清 Klotho 值的中位数将患者分为两组：低 Klotho 组（n=37，≤460 pg/ml）和高 Klotho 组（n=38，>460 pg/ml）。
高 Klotho 组的 CalcIndex 明显低于低 Klotho 组。高 Klotho 组的低 CalcIndex 发生率明显高于低 Klotho 组。与低 Klotho 组相比，高 Klotho 组全冠状动脉中度至重度 CAC 数量明显减少。血清 Klotho 水平与 CalcIndex 呈显著负相关，在估计肾小球滤过率（eGFR）<60 ml/min/1.73 m 的患者中更为显著。Logistic 回归分析显示，高 Klotho 与 CalcIndex 降低独立于经典冠状动脉危险因素和矿物质代谢标志物相关。
在接受 PCI 治疗的非透析、稳定型 CAD 患者中，高血清可溶性 Klotho 水平与 CAC 程度较低相关。
