Renal Division, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Renal Division, Department of Internal Medicine, Chi Mei Hospital Chiali, Tainan, Taiwan.
Front Endocrinol (Lausanne). 2023 Aug 24;14:1246590. doi: 10.3389/fendo.2023.1246590. eCollection 2023.
Studies on association of α-klotho levels with mortality risk in general population are relatively scarce and inconclusive. Therefore, we conducted a population-based cohort study to investigate the relationship between soluble α-klotho and all-cause mortality in a nationally representative sample of middle-aged and older adults in the United States (U.S.).
The study population was 2007-2016 National Health and Nutrition Examination Survey (NHANES) participants, totaling 13,583 adults aged 40-79 years. Participants were divided into 7 groups by septile of α-klotho levels. We linked the NHANES data to the National Death Index to determine participants' survival status. End of follow-up was participants' death date or December 31, 2019.
We observed that males, current smokers, older age, higher body mass index, and lower estimated glomerular filtration rate correlated to lower α-klotho levels, while hepatitis C virus infection correlated to higher α-klotho. The population mortality rate was 11.8 per 10,000 person-months (1,490 deaths); group 1 (the first septile) had higher mortality risk compared with group 2 through group 7. By weighted Cox regression with adjustment for potential confounders, we found that group 2 through group 6, but not group 7, were associated with 25% to 35% lower risk of all-cause mortality compared with group 1. When compared with group 4, we observed that both group 1 (HR: 1.46, 95% CI 1.13-1.88) and group 7 (HR: 1.38, 95% CI 1.09-1.74) were associated with higher mortality risk.
In summary, among middle-aged and older U.S. adults, we observed a non-linear association between soluble α-klotho and all-cause mortality, with individuals at the two extremes at increased risk of death.
关于α-klotho 水平与普通人群死亡风险之间的关联的研究相对较少且结论不一致。因此，我们进行了一项基于人群的队列研究，以调查美国（美国）中年和老年人具有代表性的样本中可溶性α-klotho 与全因死亡率之间的关系。
研究人群为 2007-2016 年国家健康和营养调查（NHANES）参与者，共包括 13583 名年龄在 40-79 岁的成年人。参与者根据α-klotho 水平的十分位数分为 7 组。我们将 NHANES 数据与国家死亡指数相关联，以确定参与者的生存状况。随访结束时为参与者的死亡日期或 2019 年 12 月 31 日。
我们观察到男性、当前吸烟者、年龄较大、体重指数较高和估算肾小球滤过率较低与α-klotho 水平降低相关，而丙型肝炎病毒感染与α-klotho 水平升高相关。人群死亡率为每 10000 人-月 11.8 人（1490 人死亡）；第 1 组（第一个十分位数）的死亡率高于第 2 组至第 7 组。通过加权 Cox 回归，调整潜在混杂因素后，我们发现第 2 组至第 6 组，而不是第 7 组，与第 1 组相比，全因死亡率降低 25%至 35%。与第 4 组相比，我们观察到第 1 组（HR：1.46，95%CI 1.13-1.88）和第 7 组（HR：1.38，95%CI 1.09-1.74）与较高的死亡率风险相关。
总之，在美国中年和老年人中，我们观察到可溶性α-klotho 与全因死亡率之间存在非线性关联，两个极端的个体死亡风险增加。
