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Association between serum α-klotho level and the prevalence of heart failure in the general population
Weimin Luo1, Na Wei1, Zhaoling Sun1
1Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, Shandong, China.
Insights
Higher serum alpha-klotho levels are linked to a lower prevalence of heart failure in American adults. This association varied significantly based on gender and race, indicating potential differences in cardiovascular health.
Area of Science:
- Cardiovascular Research
- Endocrinology
- Gerontology
Background:
- Heart failure presents a significant global health challenge, impacting morbidity and mortality worldwide.
- While animal studies suggest cardioprotective effects of alpha-klotho, its role in human cardiovascular disease remains debated.
- This study investigates the relationship between serum alpha-klotho levels and heart failure prevalence in the US general population.
Purpose of the Study:
- To examine the association between serum alpha-klotho levels and the prevalence of heart failure.
- To explore potential variations in this association based on demographic factors like gender and race.
Main Methods:
- Utilized data from 11,271 participants (aged 40-80) in the National Health and Nutrition Examination Survey (NHANES).
- Measured serum alpha-klotho levels via ELISA and categorized them into quartiles.
- Employed multivariate logistic regression, interaction, and stratified analyses to assess the association and potential modifiers.
Main Results:
- An inverse association was observed between serum alpha-klotho levels and heart failure prevalence, even after adjusting for covariates (OR: 0.76 per SD increase).
- Participants in higher quartiles of alpha-klotho showed reduced odds of heart failure compared to the lowest quartile.
- Stratified analyses indicated significant differences in the association based on gender and race.
Conclusions:
- Serum alpha-klotho level is independently associated with heart failure prevalence in the American general population.
- The observed association between alpha-klotho and heart failure is not uniform and is influenced by gender and race.
- Further research is warranted to elucidate the mechanisms underlying these demographic variations.
Background:
Heart failure is a major cause of global morbidity and mortality. Studies in laboratory animals have shown the direct protective effects of α-klotho on the cardiovascular system although it has limited expression in the heart. The association between α-klotho and cardiovascular disease is still controversial in different clinical studies. We designed a cross-sectional study in order to investigate the association between serum α-klotho level and the prevalence of heart failure in the American general population.
Methods:
The data were obtained from the National Health and Nutrition Examination Survey (NHANES), which included 11 271 participants aged 40-80 years. Serum α-klotho level was examined by enzyme-linked immunosorbent assay and divided into four quartiles for further analysis. Heart failure status was obtained from self-reported questionnaires. To estimate the association between α-klotho level and prevalence of heart failure, multivariate logistic regression analyses were conducted. Interaction and stratified analyses were performed to evaluate the potential modifiers.
Results:
After adjusting for multiple covariates, a per-standard deviation increase in serum α-klotho level was associated with a decrease in prevalence of heart failure [odds ratio (OR): 0.76, 95% confidence interval (CI): 0.68-0.85]. The ORs for participants in quartiles 2 to 4 were 0.77 (95% CI: 0.58-1.01), 0.70 (95% CI: 0.52-0.93) and 0.71 (95% CI: 0.53-0.95), respectively, compared with those in quartile 1. Stratified analysis revealed significant gender and racial differences.
Conclusion:
We revealed an independent association between serum α-klotho level and the prevalence of heart failure in the American general population. The association was not always consistent and varied according to gender and race.
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