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Huang X, Hu L, Tao S, Xue T, Hou C, Li J. Relationship between uric acid to high-density cholesterol ratio (UHR) and circulating α-klotho: evidence from NHANES 2007-2016. Lipids Health Dis 2024; 23:244. [PMID: 39123222 PMCID: PMC11312937 DOI: 10.1186/s12944-024-02234-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE To investigate the relationship between uric acid to high-density lipoprotein cholesterol ratio (UHR) and circulating α-klotho levels in U.S. adults. METHODS A cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Circulating α-klotho was defined as the dependent variable and UHR was defined as the independent variable. Multivariable linear regression was performed to assess the relationship between the independent and dependent variables. The nonlinear relationship and effect size between UHR and α-klotho were evaluated using smooth curve fitting and threshold effect analysis. Subgroup analysis and sensitivity analysis were conducted to determine the stability of the results. The diagnostic performance of UHR and α-klotho in common elderly diseases was compared using ROC (Receiver Operating Characteristic) analysis. RESULTS Among 12,849 participants, there was a negative relationship between the UHR and circulating α-klotho. In the fully adjusted overall model, each unit increase in UHR was associated with a decrease of 4.1 pg/mL in α-klotho. The threshold effect analysis showed that before the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 15.0 pg/mL in α-klotho; beyond the inflection point of 8.2, each unit increase in UHR was associated with a decrease of 2.8 pg/mL in α-klotho. Subgroup analyses and sensitivity analysis indicated that the relationship between UHR and α-klotho remained stable across most populations. The ROC diagnostic test indicated that the evaluative efficacy of UHR in diagnosing age-related diseases was comparable to that of α-klotho. CONCLUSION This study revealed that the UHR was associated with the circulating α-klotho concentration, with a negative association observed in most cases. This finding suggested that the UHR might be a promising indicator for evaluating circulating α-klotho levels.
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Affiliation(s)
- Xuanchun Huang
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Lanshuo Hu
- Xiyuan Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Shiyi Tao
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Tiantian Xue
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China
| | - Chengzhi Hou
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
| | - Jun Li
- Guang'anmen Hospital, China Academy of Traditional Chinese Medicine, Beijing, China.
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Mao T, He Q, Yang J, Jia L, Xu G. Relationship between gout, hyperuricemia, and obesity-does central obesity play a significant role?-a study based on the NHANES database. Diabetol Metab Syndr 2024; 16:24. [PMID: 38254222 PMCID: PMC10804703 DOI: 10.1186/s13098-024-01268-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/14/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Our objective was to evaluate how various measures of obesity, such as body mass index(BMI), body roundness index(BRI), and weigh adjusted waist index(WWI), influence urate levels, prevalence of gout and to compare the disparities among these obesity indicators. METHODS By analyzing the 2001-2018 National Health and Nutrition Examination Survey (NHANES), we assessed the relationship between BMI, WWI, and BRI indices and urate levels, hyperuricemia, and the prevalence of gout. Smoothed curve fitting was used to determine whether there was a nonlinear relationship between BMI,WWI, and BRI indices and urate levels, hyperuricemia, and the prevalence of gout, and threshold effects analysis was used to test this relationship. We also used ROC curves to determine the diagnostic efficacy of BMI, WWI, and BRI on the prevalence of hyperuricemia and gout. RESULTS The study incorporated a total of 29,310 participants aged over 20 years, out of which 14,268 were male. Following the adjustment for the pertinent confounding factors, it was observed that higher levels of BMI, WWI, and BRI were significantly associated with a gradual and dose-dependent increase in urate levels. In the sensitivity analysis, each unit increment in BMI, WWI, and BRI levels exhibited an 8%, 72%, and 26% respective elevation in the risk of hyperuricemia, as well as a 5%, 31%, and 15% respective increase in the risk of gout. Dose-response curves provided evidence of a linear positive correlation between BMI, WWI, BRI, and urate levels, as well as the prevalence of hyperuricemia and gout. Based on the response from the ROC curve, overall, the diagnostic efficacy of BRI for hyperuricemia and gout surpasses that of BMI. CONCLUSION The central obesity indices WWI and BRI levels are superior to BMI in detecting the prevalence of urate levels, hyperuricemia, and gout, and although a clear causal relationship has not yet been established, it is important to recognize the impact of central obesity on uric acid levels and to give it due attention.
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Affiliation(s)
- Tongjun Mao
- Department of Rheumatology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Qian He
- Department of Rheumatology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Junping Yang
- Department of General Practice, Wuhu City SecondPeoplès Hospital, Wuhu, Anhui, China
| | - Lanlan Jia
- Department of Rheumatology, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, China
| | - Guofei Xu
- Anhui Normal University School of Educational Sciences, Wuhu, China.
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Xiao Y, Xiao Z. Association between Serum Klotho and Kidney Stones in US Middle-Aged and Older Individuals with Diabetes Mellitus: Results from 2007 to 2016 National Health and Nutrition Survey. Am J Nephrol 2023; 54:224-233. [PMID: 37231844 PMCID: PMC10614277 DOI: 10.1159/000531045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Kidney stones (KSs) are associated with hematuria and renal failure and pose a significant clinical and public health concern. Diabetes is associated with a higher risk of KSs. In addition, α-Klotho (Klotho), as a novel antiaging protein, is associated with kidney disease, diabetes, and complications and may participate in the pathological mechanism of KSs. However, studies that used large population-based database research are limited. Therefore, this study aimed to investigate whether or not KS prevalence is associated with serum Klotho levels in diabetic adults in the USA. METHODS This nationally representative cross-sectional study used data on diabetic adults in the USA aged 40-79 years from the National Health and Nutrition Examination Survey 2007-2016 cycles. Multivariate logistic regression models were used to calculate the association between Klotho and KS. Restricted cubic splines were used to further test for linearity and explore the shape of the dose-response association. Moreover, we performed stratified and interaction analyses to see if the relationship was stable in different subgroups. RESULTS Among the 3,537 diabetic patients included in this study (mean age of 61.4 years, consisting of 51.3% males), 543 participants (15.4%) suffered from KS. In the fully adjusted model, Klotho was negatively associated with KS (OR = 0.72; 95% CI: 0.54-0.96; p = 0.027). A negative relationship was observed between the occurrence of KS and Klotho (nonlinear: p = 0.560). Some differences in the association between Klotho and KS were found in stratified analyses; however, these differences lacked statistical significance. CONCLUSIONS Serum Klotho was negatively associated with the incidence of KS; when ln-transformed Klotho concentration increased by 1 unit, the risk of KS was 28% lower.
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Affiliation(s)
- Yuxiuzi Xiao
- Department of the First Clinical Medicne, Gannan Medical University, Ganzhou, China
| | - Zuomiao Xiao
- Department of Clinical Laboratory, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, China
- Department of Immunology and Microbiology, School of Medicine, Xi'an Jiaotong University, Xi'an, China
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Abraham CR, Li A. Aging-suppressor Klotho: Prospects in diagnostics and therapeutics. Ageing Res Rev 2022; 82:101766. [PMID: 36283617 DOI: 10.1016/j.arr.2022.101766] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The protein Klotho (KL) was first discovered in KL-deficient mice, which developed a syndrome similar to premature aging in humans. Since then, KL has been implicated in multiple molecular signaling pathways and diseases. KL has been shown to have anti-aging, healthspan and lifespan extending, cognitive enhancing, anti-oxidative, anti-inflammatory, and anti-tumor properties. KL levels decrease with age and in many diseases. Therefore, it has been of great interest to develop a KL-boosting or restoring drug, or to supplement endogenous Klotho with exogenous Klotho genetic material or recombinant Klotho protein, and to use KL levels in the body as a marker for the efficacy of such drugs and as a biomarker for the diagnosis and management of diseases. OBJECTIVE The goal of this study was to provide a comprehensive review of KL levels across age groups in individuals who are healthy or have certain health conditions, using four sources: blood, cerebrospinal fluid, urine, and whole biopsy/necropsy tissue. By doing so, baseline KL levels can be identified across the lifespan, in the absence or presence of disease. In turn, these findings can be used to guide the development of future KL-based therapeutics and biomarkers, which will heavily rely on an individual's baseline KL range to be efficacious. METHODS A total of 65 studies were collected primarily using the PubMed database. Research articles that were published up to April 2022 were included. Statistical analysis was conducted using RStudio. RESULTS Mean and median blood KL levels in healthy individuals, mean blood KL levels in individuals with renal conditions, and mean blood KL levels in individuals with metabolic or endocrine conditions were shown to decrease with age. Similarly, CSF KL levels in patients with AD also declined compared with age-matched controls. CONCLUSIONS The present study confirms the trend that KL levels in blood decrease with age in humans, among those who are healthy, and even further among those with renal and endocrine/metabolic illnesses. Further, by drawing this trend from multiple published works, we were able to provide a general idea of baseline KL ranges, specifically in blood in these populations. These data add to the current knowledge on normal KL levels in the body and how they change with time and in disease, and can potentially support efforts to create KL-based treatments and screening tools to better manage aging, renal, and metabolic/endocrine diseases.
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Affiliation(s)
- Carmela R Abraham
- Department of Biochemistry, Boston University School of Medicine, USA; Department of Pharmacology & Experimental Therapeutics, Boston University School of Medicine, USA.
| | - Anne Li
- Division of Graduate Medical Sciences, Boston University School of Medicine, Boston, MA, USA.
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Xie H, Li N, Zhou G, Liu Q, Wang H, Han J, Shen L, Yu P, Chen J, Chen X. Plasma S-Klotho level affects the risk of hyperuricemia in the middle-aged and elderly people. Eur J Med Res 2022; 27:262. [PMID: 36411464 PMCID: PMC9677891 DOI: 10.1186/s40001-022-00875-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/29/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Soluble Klotho (S-Klotho) is an anti-aging protein mainly secreted by the kidneys. Hyperuricemia is prevalent among middle-aged and elderly individuals, which affects the development of various chronic diseases. However, there are relatively few studies investigating the association between plasma S-Klotho levels and hyperuricemia in middle-aged and elderly individuals. This study sought to clarify the relationship between S-Klotho and the risk of hyperuricemia in middle-aged and elderly people. METHODS During 2007-2016, a total of 50,588 people participated in the National Health and Nutrition Examination Survey. Finally, 12,441 middle-aged and elderly people (aged 40-79) completed the soluble Klotho tests and had obtained complete data. S-Klotho was detected by ELISA kit, and the relationship between S-Klotho and hyperuricemia was assessed by multiple logistic regression. Hyperuricemia is defined as serum uric acid levels higher than or equal to 420 mmol/l in men and 360 mmol/l in women. RESULTS In the middle-aged and elderly, plasma S-Klotho levels were negatively correlated with hyperuricemia, and there was a saturation effect. The inflection point of S-Klotho was 927.8 pg/ml (logarithmic likelihood ratio test = 0.002). When plasma S-Klotho < 927.8 pg/ml, the prevalence of hyperuricemia in middle-aged and elderly individuals with higher levels of S-Klotho decreased by 25.6% compared with those with low levels of S-Klotho [Q4 vs Q1, OR: 0.744, 95%CI: (0.634, 0.874), P < 0.001]; In different age groups, S-Klotho had a significantly greater effect on hyperuricemia in middle-aged people [age: 40-65 years, Q4 vs Q1, OR (95%CI): 0.69 (0.58, 0.82), P < 0.001; Age > 65 years: Q4 vs Q1, OR (95%CI): 0.72 (0.56, 0.92), P = 0.008)].When the level of S-Klotho was higher, the risk of hyperuricemia in men was lower than that in women [male: Q4 vs Q1, OR (95%CI): 0.67 (0.56, 0.81), P < 0.001; female: Q4 vs Q1 (95%CI):0.72 (0.58, 0.88), P < 0.001]. CONCLUSIONS In middle-aged and elderly individuals, plasma S-Klotho levels were inversely correlated with hyperuricemia, with a saturation effect. Given the limitations of the research results, the underlying mechanism between S-Klotho and hyperuricemia should be further explored.
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Affiliation(s)
- Haitao Xie
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China ,grid.410745.30000 0004 1765 1045First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ning Li
- grid.410745.30000 0004 1765 1045First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Guowei Zhou
- grid.410745.30000 0004 1765 1045First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qian Liu
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China ,grid.410745.30000 0004 1765 1045First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Haiyan Wang
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China ,grid.410745.30000 0004 1765 1045First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Han
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China
| | - Le Shen
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China
| | - Peng Yu
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China
| | - Jiandong Chen
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China
| | - Xiaohu Chen
- grid.410745.30000 0004 1765 1045Department of Cardiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China ,grid.412676.00000 0004 1799 0784Department of Cardiology, Jiangsu Province Hospital of Chinese Medicine, No. 155, Hanzhong Road, Nanjing, 210004 China
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Lisowska KA, Storoniak H, Soroczyńska-Cybula M, Maziewski M, Dębska-Ślizień A. Serum Levels of α-Klotho, Inflammation-Related Cytokines, and Mortality in Hemodialysis Patients. J Clin Med 2022; 11:6518. [PMID: 36362746 PMCID: PMC9656457 DOI: 10.3390/jcm11216518] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 08/18/2023] Open
Abstract
It has been hypothesized that α-Klotho deficiency might contribute to chronic inflammation in patients with end-stage renal disease (ESRD), especially those on hemodialysis (HD). Serum Klotho levels by some authors are considered a potential predictor of cerebrovascular events. Therefore, we analyzed serum levels of α-Klotho with ELISA and inflammation-related cytokines in HD patients. Sixty-seven HD patients and 19 healthy people were recruited between November 2017 and June 2021. A Cytometric Bead Array (CBA) was used to determine the level of different cytokines: IL-12p70, TNF, IL-10, IL-6, IL-1β, and IL-8. A human Klotho ELISA kit was used to determine the level of α-Klotho in the plasma samples of HD patients. There was no difference in serum levels of α-Klotho between HD patients and healthy people. Patients had increased serum IL-6 and IL-8. Significant positive correlations existed between the concentration of α-Klotho and the serum concentrations of IL-12p70, IL-10, and IL-1β. However, in a multivariable linear regression analysis, only patients' age was associated independently with α-Klotho level. Serum α-Klotho was not associated with higher mortality risk in HD patients. While these results draw attention to potential relationships between α-Klotho proteins and inflammatory markers in HD patients, our cross-sectional study could not confirm the pathogenic link between α-Klotho, inflammation, and cardiovascular mortality.
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Affiliation(s)
| | - Hanna Storoniak
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
| | - Monika Soroczyńska-Cybula
- Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Mateusz Maziewski
- Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, 80-211 Gdańsk, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, 80-214 Gdańsk, Poland
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