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Serum Klotho Modifies the Associations of 25-Hydroxy Vitamin D With All-Cause and Cardiovascular Mortality.
Chen, Zhuohui; Liu, Menghui; Xu, Xingfeng; He, Lixiang; Wang, Peng; Cai, Xiaojie; Huang, Rihua; Zhang, Shaozhao; Xu, Xinghao; Lai, Yuhui; Huang, Yiquan; Li, Miaohong; Lin, Yifen; Xie, Peihan; Liao, Xinxue; Zhuang, Xiaodong; Guo, Yue.
Afiliação
  • Chen Z; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • Liu M; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Xu X; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • He L; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Wang P; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • Cai X; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Huang R; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • Zhang S; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Xu X; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • Lai Y; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Huang Y; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • Li M; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Lin Y; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • Xie P; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Liao X; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
  • Zhuang X; NHC Key Laboratory of Assisted Circulation (Sun Yat-sen University), Guangzhou, Guangdong 510080, P. R. China.
  • Guo Y; Department of Cardiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, P.R. China.
J Clin Endocrinol Metab ; 109(2): 581-591, 2024 Jan 18.
Article em En | MEDLINE | ID: mdl-37579499
ABSTRACT

BACKGROUND:

The association between 25-hydroxyvitamin D and mortality remains controversial. Klotho, a biomarker of vitamin D activation and metabolism, may play a key role in this association. However, it is unclear whether the association between vitamin D deficiency and mortality risk is modified by klotho levels. Therefore, this study investigated the joint association of serum 25-hydroxyvitamin D [25(OH)D] and klotho with mortality risk in American community-dwelling adults.

METHODS:

A total of 9870 adults from the National Health and Nutrition Examination Survey (2007-2016) were included in our study. Mortality data were ascertained by linking participants to National Death Index records. Cox proportional hazards models were used to assess the association among serum 25(OH)D, serum klotho, and all-cause and cardiovascular disease (CVD) mortality.

RESULTS:

We found a significant interaction between klotho and serum 25(OH)D in all-cause mortality (P = .028). With klotho > 848.4 pg/mL (risk threshold on mortality), no significant all-cause and CVD mortality risk was observed at any level of serum 25(OH)D. However, with klotho < 848.4 pg/mL, a significant all-cause and CVD mortality risk was observed with serum 25(OH)D < 50 nmol/L [hazards ratio (HR), 1.36; 95% confidence interval (CI), 1.10-1.69; HR, 1.78; 95% CI, 1.16-3.45) and serum 25(OH)D of continuous variable (HR, 0.98; 95% CI, .97-.99; HR, 0.98; 95% CI, .98-.99). In addition, vitamin D metabolism disruption accessed by the combination of decreasing serum 25(OH)D (<50 nmol/L) and klotho (<848.4 pg/mL) was associated with significant all-cause mortality (HR, 1.48; 95% CI, 1.11-1.96) and CVD mortality (HR, 2.36; 95% CI, 1.48-3.75).

CONCLUSIONS:

Vitamin D-associated mortality risk is observed only with concurrently decreasing klotho, indicating that vitamin D metabolism dysfunction increases the risk of mortality. Klotho levels could help predict long-term mortality outcomes and thus may be useful concurrently for guiding vitamin D supplementation therapy decision-making in populations with vitamin D deficiency.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Deficiência de Vitamina D / Doenças Cardiovasculares Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: J Clin Endocrinol Metab Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Deficiência de Vitamina D / Doenças Cardiovasculares Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Adult / Humans Idioma: En Revista: J Clin Endocrinol Metab Ano de publicação: 2024 Tipo de documento: Article