Unidad de Investigación, Hospital Universitario Nuestra Señora de Candelaria, 38010 Santa Cruz de Tenerife, Spain.
GEENDIAB (Grupo Español para el Estudio de la Nefropatía Diabética), Sociedad Española de Nefrología, 39008 Santander, Spain.
Int J Mol Sci. 2023 Aug 30;24(17):13456. doi: 10.3390/ijms241713456.
Circulating Klotho levels are significantly reduced in subjects with type 2 diabetes mellitus (T2DM) and in kidney disease patients. In this work, the relationship between Klotho levels and the coronary artery disease (CAD) burden in subjects with T2DM and preserved kidney function was analyzed. For this, we performed a cross-sectional case-control study involving 133 subjects with T2DM and 200 age-, sex- and CAD-incidence-matched, non-diabetic patients undergoing non-emergency diagnostic coronary angiography. All of them were non-albuminuric and with normal glomerular filtration rates. The concentrations of serum Klotho, fibroblast growth factor 23, and inflammatory markers were also measured. As expected, the serum Klotho concentration was lower in the T2DM group (12.3% lower, = 0.04). However, within the group of patients with T2DM, those subjects with CAD presented significantly higher Klotho levels than those without significant coronary stenosis (314.5 (6.15-562.81) vs. 458.97 (275.2-667.2) pg/mL; = 0.02). Multiple regression analysis revealed that serum Klotho was positively related with stenosis values exclusively in subjects with T2DM (adjusted R2 = 0.153, < 0.01). Moreover, logistic regression analysis showed that Klotho was positively associated with the presence of significant CAD in the group of T2DM patients (OR: 1.001; = 0.041). Our data suggest that higher levels of circulating Klotho in subjects with T2DM and preserved kidney function are associated with the presence of significant CAD.
循环 Klotho 水平在 2 型糖尿病（T2DM）患者和肾病患者中显著降低。在这项工作中，分析了 T2DM 患者肾功能正常且 Klotho 水平与冠状动脉疾病（CAD）负担之间的关系。为此，我们进行了一项横断面病例对照研究，纳入了 133 名 T2DM 患者和 200 名年龄、性别和 CAD 发生率匹配、非糖尿病患者，他们均无白蛋白尿和正常肾小球滤过率。还测量了血清 Klotho、成纤维细胞生长因子 23 和炎症标志物的浓度。正如预期的那样，T2DM 组的血清 Klotho 浓度较低（低 12.3%， = 0.04）。然而，在 T2DM 患者组中，那些患有 CAD 的患者的 Klotho 水平明显高于那些没有明显冠状动脉狭窄的患者（314.5（6.15-562.81）与 458.97（275.2-667.2）pg/mL； = 0.02）。多元回归分析显示，血清 Klotho 仅与 T2DM 患者的狭窄值呈正相关（调整后的 R2 = 0.153， < 0.01）。此外，逻辑回归分析显示，Klotho 与 T2DM 患者中存在显著 CAD 呈正相关（OR：1.001； = 0.041）。我们的数据表明，循环 Klotho 水平较高的 T2DM 患者和肾功能正常患者与存在显著 CAD 有关。
