BMC Nephrol. 2018;19(1):51.

The association between soluble klotho and cardiovascular parameters in chronic kidney disease: results from the KNOW-CKD study.

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제1저자 김효진 · 교신저자 오국환

PMID 29506503 PMC5838864 DOI 10.1186/s12882-018-0851-3 IF 2.9 신장내과

소속 (6)

Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju-si, Gyeongsangbuk-do, South Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Department of Internal Medicine, Inje University, Busan Paik Hospital, Busan, South Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Medical Research Collaborating Center, Seoul National University Hospital and Seoul, National University College of Medicine, Seoul, South Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. khoh@snu.ac.kr.

Abstract

BACKGROUND Klotho, a protein linked to aging, has emerged as a pivotal player in mineral bone metabolism and might explain the relationship between chronic kidney disease (CKD) and cardiovascular disease (CVD). The present study aimed to investigate the association between serum klotho and cardiac parameters from a large-scale Korean CKD cohort.

METHODS We analyzed 2101 participants from KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) cohort who had been measured for serum klotho levels. Left ventricular hypertrophy evaluated by left ventricular mass index (LVMI) and arterial stiffness measured by brachial-to-ankle pulse wave velocity (baPWV) were explored as cardiovascular parameters.

RESULTS Patients were 53.6 ± 12.2 years old and 61.1% were male. The mean estimated glomerular filtration rate (eGFR) was 53.0 ± 30.7 mL/min/1.73m². The median serum klotho level was 536 (interquartile range [IQR]: 420-667) pg/mL. Advanced CKD stages were associated with lower serum klotho levels (P < 0.001, P for linear trend < 0.001). Ascending quartiles of klotho were significantly associated with decreased LMVI (P < 0.001, P for linear trend< 0.001). A multivariable linear regression model showed serum klotho had a significant inverse association with LVMI (β - 0.04; 95% CI [confidence interval] -0.004, - 0.00007; P = 0.041). However, there was no significant association between serum klotho and baPWV after adjustment (β 0.003; 95% CI -0.04, 0.05; P = 0.876).

TRIAL REGISTRATION This trial was registered on ClinicalTrials.gov on 28 June 2012 ( NCT01630486 ).

CONCLUSIONS Serum klotho was an independent biomarker of LVMI, but not arterial stiffness.

Keywords

Chronic kidney diseaseLeft ventricular hypertrophyLeft ventricular mass indexPulse wave velocitySerum klothoSoluble klotho

Figures

**Fig. 1** Serum klotho levels across CKD stages. Advanced CKD stages were associated with lower serum klotho levels (P < 0.001, P for linear trend < 0.001). NS, non significant

**Fig. 2** Mean left ventricular mass index across the quartiles of klotho. Ascending quartiles of klotho were significantly associated with decreased left ventricular mass index (P < 0.001, P for linear trend < 0.001). NS, non significant

**Fig. 3** Mean pulse wave velocity across the quartiles of klotho. a Brachial-to-ankle pulse wave velocity had a tendency of decreasing across the quartiles of klotho. b Ascending quartiles of klotho were significantly associated with decreased heart-to-femoral PWV (P = 0.022, P for linear trend = 0.002). PWV, pulse wave velocity; NS, non significant

그림 출처: PubMed Central 공개 논문 (PMC5838864)

Conflict of interest statement

ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The study protocol was approved by the ethical committee of each participating clinical center, including the Institutional Review Boards of Seoul National University Hospital, Severance Hospital, Kangbuk Samsung Medical Center, Seoul St. Mary’s Hospital, Gil Hospital, Eulji General Hospital, Chonnam National University Hospital, and Busan Paik Hospital. All participating patients provided written informed consent. The study protocol was in accordance with the principles of the Declaration of Helsinki. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTEREST: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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