Chen Dawei, Chen Mengxing, Qi Zhixiang, Tang Yumei, Wan Xin
Department of Nephrology, Nanjing First Hospital, Nanjing Medical University, 68 Changle Road, Nanjing, Jiangsu, China.
Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China.
BMC Nephrol. 2024 Dec 18;25(1):455. doi: 10.1186/s12882-024-03870-x.
The relationship between serum klotho level and albuminuria is unknown in middle-aged and elderly participants without diabetes mellitus (DM). Therefore, we will investigate the association between serum klotho level and albuminuria in middle-aged and elderly participants without DM.
Participants (aged 40-79) were from the five continuous cycles (2007-2016) of the National Health and Nutrition Examination Survey (NHANES). Multiple logistic regression was performed to investigate the association between serum klotho level and albuminuria.
9217 participants were included in the present study. 47.6% of the participants were male. The average age of the overall participants was 56.3 years (40-79 years). Overall, 823 participants with albuminuria were identified. After adjusted confounders (age, gender, marital status, ethnicity, family income to poverty ratio, education, body mass index, smoke, charlson comorbidity index, hypertension, hyperlipidemia, angiotensin converting enzyme inhibitor/angiotonin receptor blocker, and estimated glomerular filtration rate), participants with a high serum klotho level had a decreased risk for albuminuria. Compared with the lowest serum klotho level (Tertile 1), participants in Tertile 2 (odds ratio [OR] 0.83, 95% CI 0.70-0.99, P = 0.044) and Tertile 3 (OR 0.76, 95% CI 0.63-0.91, P = 0.003) had a lower risk of albuminuria (P for trend = 0.002). The stratified analysis showed that serum klotho level was still negatively associated with albuminuria in the subgroups, and statistically significant interactions were not observed in the subgroups (all P values for interactions > 0.05, except for the hypertension subgroup).
In middle-aged and elderly participants without DM, a high serum klotho level is associated with a decreased risk of albuminuria. In the future, the mechanism of the interaction between klotho and albuminuria needs to be elucidated to find new treatment targets for individuals without DM who suffer from albuminuria.
在无糖尿病（DM）的中老年参与者中，血清α-klotho水平与蛋白尿之间的关系尚不清楚。因此，我们将研究无DM的中老年参与者血清α-klotho水平与蛋白尿之间的关联。
参与者（年龄40 - 79岁）来自国家健康与营养检查调查（NHANES）的五个连续周期（2007 - 2016年）。采用多因素logistic回归分析血清α-klotho水平与蛋白尿之间的关联。
本研究共纳入9217名参与者。47.6%的参与者为男性。所有参与者的平均年龄为56.3岁（40 - 79岁）。总体上，共识别出823名有蛋白尿的参与者。在调整混杂因素（年龄、性别、婚姻状况、种族、家庭收入与贫困率、教育程度、体重指数、吸烟、查尔森合并症指数、高血压、高脂血症、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂以及估算肾小球滤过率）后，血清α-klotho水平较高的参与者蛋白尿风险降低。与最低血清α-klotho水平组（三分位数1）相比，三分位数2组（比值比[OR] 0.83，95%可信区间0.70 - 0.99，P = 0.044）和三分位数3组（OR 0.76，95%可信区间0.63 - 0.91，P = 0.003）的蛋白尿风险较低（趋势P值 = 0.002）。分层分析显示，在各亚组中血清α-klotho水平仍与蛋白尿呈负相关，且在各亚组中未观察到具有统计学意义的交互作用（所有交互作用P值均> 0.05，但高血压亚组除外）。
在无DM的中老年参与者中，血清α-klotho水平较高与蛋白尿风险降低相关。未来，需要阐明α-klotho与蛋白尿之间相互作用的机制，以便为患蛋白尿的无DM个体找到新的治疗靶点。
