Association between serum Klotho and thrombocytopenia in middle-aged and older adults: A cross-sectional study based...

Evidence regarding the association between serum Klotho levels and thrombocytopenia remains limited. This study aimed to evaluate the relationship between serum Klotho and thrombocytopenia. This study used data from the National Health and Nutrition Examination Survey conducted between 2007 and 2016 to investigate the association between serum Klotho levels and thrombocytopenia in middle-aged and older individuals. Weighted multivariable logistic regression, interaction subgroup analysis, restricted cubic splines and threshold effect analysis were used to examine the correlation between serum Klotho levels and thrombocytopenia. The study included 13,716 individuals, among whom thrombocytopenia was present in 4.5% of the participants. The multivariate adjusted odds ratio (OR) (95% CI) for T2 to T3 was 1.19 (0.86-1.63) and 1.50 (1.12-2.01), respectively. The risk of developing thrombocytopenia was significantly higher in the T3 group compared to T1 (P = .007). Smooth curve fitting revealed a nonlinear association between serum Klotho and thrombocytopenia (P < .001), with an inflection point at 900 pg/mL. Individuals with higher serum Klotho levels were significantly associated with increased odds of thrombocytopenia, particularly among those with serum Klotho concentrations ≥ 900 pg/mL (per SD increment: OR, 1.24; 95% CI: 1.08-1.43). We observed that higher serum Klotho levels (≥900 pg/mL) were significantly associated with the presence of thrombocytopenia in the general population. Given the cross-sectional design of the study, causality cannot be inferred. The elevated Klotho levels may reflect a compensatory response, and further longitudinal and mechanistic studies are needed to clarify the underlying biological mechanisms.