Tang Yuchen, Lei Miao, Dong Wei, Liu Zeyu, Jiang Wei, Hao Jie, Hu Zhenming
Department of Orthopedics, University-Town Hospital of Chongqing Medical University, Chongqing, China.
Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
BMC Public Health. 2025 Apr 9;25(1):1332. doi: 10.1186/s12889-025-22540-7.
Klotho, a protein known for its significant involvement in the aging process and age-related diseases, has been demonstrated to be inextricably linked to osteoporosis. Nevertheless, the relationship between serum Klotho levels and mortality risk among individuals with osteoporosis has not been definitively established. Therefore, the purpose of the current research is to examine the potential relationship between serum Klotho levels and mortality risk in individuals aged 40 and above with osteoporosis.
The current study included adults aged 40 years and older diagnosed with osteoporosis from the National Health and Nutrition Examination Survey. Osteoporosis diagnosis was based on a history of osteoporosis or bone mineral density. Moreover, Cox proportional hazards regression, Kaplan-Meier (KM) curves, and restricted cubic spline (RCS) curves were utilized to assess the relationship between Klotho levels and mortality risk. In addition, subgroup analysis was performed using stratification and interaction analysis for all covariates.
A total of 1004 participants (median age: 65 years) with a median follow-up of 9.33 years were included in the final analysis. This study found that serum Klotho levels established a U-shaped relationship with the risk of all-cause mortality in individuals with osteoporosis, with a nadir of Klotho levels was approximately 900 pg/mL, in which lower (< 850 pg/mL) or higher (> 950 pg/mL) Klotho levels were significantly associated with an increased risk of all-cause mortality. Moreover, the results of subgroup analysis indicated that the associations between Klotho levels and mortality risk were modified by several factors, especially a history of hypertension. Specifically, Klotho levels established an L-shaped relationship with the risk of all-cause mortality among participants with a history of hypertension, while a positive and linear relationship with the risk of all-cause mortality among those without a history of hypertension.
For individuals with osteoporosis, it is necessary to be alert to cases with high or low Klotho levels, which may potentially indicate an increased mortality risk.
klotho蛋白因在衰老过程和与年龄相关的疾病中发挥重要作用而闻名，已被证明与骨质疏松症有着千丝万缕的联系。然而，骨质疏松症患者血清klotho水平与死亡风险之间的关系尚未明确确立。因此，本研究的目的是探讨40岁及以上骨质疏松症患者血清klotho水平与死亡风险之间的潜在关系。
本研究纳入了来自美国国家健康与营养检查调查的40岁及以上被诊断为骨质疏松症的成年人。骨质疏松症的诊断基于骨质疏松症病史或骨密度。此外，采用Cox比例风险回归、Kaplan-Meier（KM）曲线和受限立方样条（RCS）曲线来评估klotho水平与死亡风险之间的关系。此外，对所有协变量进行分层和交互分析以进行亚组分析。
最终分析纳入了1004名参与者（中位年龄：65岁），中位随访时间为9.33年。本研究发现，骨质疏松症患者血清klotho水平与全因死亡风险呈U形关系，klotho水平最低点约为900 pg/mL，其中较低（<850 pg/mL）或较高（>950 pg/mL）的klotho水平与全因死亡风险增加显著相关。此外，亚组分析结果表明，klotho水平与死亡风险之间的关联受到几个因素的影响，尤其是高血压病史。具体而言，klotho水平与有高血压病史的参与者的全因死亡风险呈L形关系，而与无高血压病史的参与者的全因死亡风险呈正线性关系。
对于骨质疏松症患者，有必要警惕klotho水平高或低的情况，这可能预示着死亡风险增加。
