Department of Nephrology, Huai'an Hospital Affiliated to Xuzhou Medical University and Huai'an Second People's Hospital, Huaian, 223002, Jiangsu, China.
BMC Nephrol. 2023 Feb 16;24(1):38. doi: 10.1186/s12882-023-03081-w.
The role of Klotho as a multifunctional protein in anemia is unclear. This study aimed to determine the association between anemia and serum Klotho concentrations in middle-aged and elderly populations.
In this cross-sectional study, we used data collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2016. A total of 13,357 individuals who received serum Klotho measurements, biochemical tests, and demographic surveys were analyzed. Multivariate linear regression models adjusting for covariates were used to investigate the associations between anemia and serum Klotho.
Multivariable regression showed that serum Klotho correlates positively with hemoglobin and red blood cells and inversely with red cell distribution width. After adjusting for all covariates, compared with Q4, there was a significantly increased risk of anemia in serum Klotho quartiles 1 to 2 (OR=1.54, 95% CI:1.21-1.95, P=0.002; OR=1.30, 95% CI:1.02-1.64, P=0.042,respectively). Segmented regression showed that for every 100 pg/mL increase in serum Klotho <9.746 pg/mL, the risk of anemia was reduced by 10.9%, and this reduction was significant (P<0.001). Furthermore, stratified analyses yielded a stronger association between reduced anemia and high levels of Klotho in men and those with diabetes (P< 0.05 for interaction). However, this association was not found to be significantly altered by chronic kidney disease.
In summary, we indicated that low serum Klotho is associated with an increased likelihood of anemia using a nationally representative sample of middle-aged and older adults.
Klotho 作为一种多功能蛋白在贫血中的作用尚不清楚。本研究旨在确定中年和老年人贫血与血清 Klotho 浓度之间的关系。
在这项横断面研究中，我们使用了 2007-2016 年全国健康和营养调查（NHANES）的数据。共分析了 13357 名接受血清 Klotho 测量、生化检查和人口统计学调查的个体。使用调整协变量的多变量线性回归模型来研究贫血与血清 Klotho 之间的关系。
多变量回归显示，血清 Klotho 与血红蛋白和红细胞呈正相关，与红细胞分布宽度呈负相关。在调整所有协变量后，与 Q4 相比，血清 Klotho 四分位 1 到 2 时贫血的风险显著增加（OR=1.54，95%CI：1.21-1.95，P=0.002；OR=1.30，95%CI：1.02-1.64，P=0.042）。分段回归显示，血清 Klotho 每增加 100pg/ml（<9.746pg/ml），贫血的风险降低 10.9%，且这种降低具有统计学意义（P<0.001）。此外，分层分析显示，在男性和糖尿病患者中，高水平的 Klotho 与贫血的发生率降低之间的相关性更强（交互作用 P<0.05）。然而，这种相关性并没有因慢性肾病而发生显著改变。
总之，我们使用中年和老年人的全国代表性样本表明，低血清 Klotho 与贫血的可能性增加有关。
