Department of Critical Care Medicine, Ningbo Medical Center Lihuili Hospital, 315100, Ningbo, China.
Zhejiang Provincial Key Lab of Geriatrics and Geriatrics Institute of Zhejiang Province, Department of Geriatrics, Zhejiang Hospital, 310030, Hangzhou, China.
BMC Pulm Med. 2024 Jan 29;24(1):61. doi: 10.1186/s12890-024-02864-7.
Klotho is an anti-aging protein that has multiple functions and may play a key role in the pathogenesis and progression of chronic respiratory diseases such as chronic obstructive pulmonary disease (COPD). Fractional Exhaled Nitric Oxide (FeNO) is a non-invasive and novel biomarker that has the advantages of being simple, fast and reproducible. It can effectively assess the degree of airway inflammation in diseases such as asthma and COPD. Despite these insights, the relationship between serum Klotho levels and FeNO has not been explored yet.
Leveraging data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2012, we investigated the correlation between FeNO and serum Klotho levels. This association was scrutinized both as continuous variables and within quartile distributions, utilizing the Kruskal-Wallis H test. The correlation between the two variables was assessed through Spearman rank analysis. Employing survey weight-adjusted linear regression models, we gauged the strength of these associations.
This study included 6,527 participants with a median FeNO level of 14.5 parts per billion (ppb). We found that FeNO levels varied significantly across different quartiles of Klotho protein (H = 7.985, P = 0.046). We also found a significant positive correlation between serum Klotho levels and FeNO levels in the whole population (Spearman's rho = 0.029, P = 0.019). This correlation remained significant after adjusting for covariates such as age, gender, lung function, smoking status, alcohol use, BMI, cardiovascular disease (including hypertension, heart failure, coronary heart disease, and myocardial infarction), diabetes, inflammatory markers, serum vitamin D level and BUN (P < 0.05 for all). Furthermore, this correlation was stronger at the high (K3) and super high (K4) levels of Klotho than at the low (K1) and medium (K2) levels (β = 1.979 ppb and β = 1.993 ppb for K3 and K4 vs. K1, respectively; 95% CI: 0.497 ~ 2.953 and 95% CI: 0.129 ~ 2.827, respectively; P = 0.007 and P = 0.032, respectively). The β coefficient for serum Klotho was 0.002 ppb/pg/ml.
Our study illuminates a positive correlation between serum Klotho levels and FeNO. Further study is needed to verify the causality of this association and elucidate the underlying mechanisms.
Klotho 是一种抗衰老蛋白，具有多种功能，可能在慢性呼吸道疾病（如慢性阻塞性肺疾病，COPD）的发病机制和进展中起关键作用。呼出气一氧化氮分数（FeNO）是一种非侵入性和新型的生物标志物，具有简单、快速和可重复的优点。它可以有效评估哮喘和 COPD 等疾病的气道炎症程度。尽管有这些见解，但血清 Klotho 水平与 FeNO 之间的关系尚未得到探索。
利用 2007 年至 2012 年国家健康和营养检查调查（NHANES）的数据，我们研究了 FeNO 与血清 Klotho 水平之间的相关性。使用 Kruskal-Wallis H 检验对这两个变量进行了连续变量和四分位分布的相关性分析。通过 Spearman 秩分析评估了这两个变量之间的相关性。使用调查权重调整线性回归模型来衡量这些关联的强度。
这项研究共纳入了 6527 名参与者，中位 FeNO 水平为 14.5 皮克/分升（ppb）。我们发现，Klotho 蛋白的不同四分位组之间的 FeNO 水平有显著差异（H=7.985，P=0.046）。我们还发现，在整个人群中，血清 Klotho 水平与 FeNO 水平之间存在显著的正相关（Spearman 的 rho=0.029，P=0.019）。在调整年龄、性别、肺功能、吸烟状态、饮酒、体重指数、心血管疾病（包括高血压、心力衰竭、冠心病和心肌梗死）、糖尿病、炎症标志物、血清维生素 D 水平和 BUN 等因素后，这种相关性仍然显著（所有 P<0.05）。此外，Klotho 的高水平（K3）和超高水平（K4）与低水平（K1）和中水平（K2）相比，这种相关性更强（K3 和 K4 与 K1 相比，β=1.979 ppb 和 β=1.993 ppb；95%CI：0.4972.953 和 95%CI：0.1292.827；P=0.007 和 P=0.032）。血清 Klotho 的β系数为 0.002 ppb/pg/ml。
我们的研究揭示了血清 Klotho 水平与 FeNO 之间的正相关。需要进一步的研究来验证这种关联的因果关系，并阐明潜在的机制。
