Association between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES database
Abstract Background The α-klotho is crucial in diabetes and its related complications. This study seeks to explore the link between α-klotho levels and the risk of diabetic kidney disease (DKD) as well as all-cause and cardiovascular mortality among individuals with type 2 diabetes mellitus (T2DM)....
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| Format: | Article |
| Language: | English |
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BMC
2025-05-01
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| Series: | Diabetology & Metabolic Syndrome |
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| Online Access: | https://doi.org/10.1186/s13098-025-01711-x |
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| author | Yi Kang Qian Jin Mengqi Zhou Huijuan Zheng Danwen Li Jingwei Zhou Jie Lv Yaoxian Wang |
| author_facet | Yi Kang Qian Jin Mengqi Zhou Huijuan Zheng Danwen Li Jingwei Zhou Jie Lv Yaoxian Wang |
| author_sort | Yi Kang |
| collection | DOAJ |
| description | Abstract Background The α-klotho is crucial in diabetes and its related complications. This study seeks to explore the link between α-klotho levels and the risk of diabetic kidney disease (DKD) as well as all-cause and cardiovascular mortality among individuals with type 2 diabetes mellitus (T2DM). Methods The investigation involved 126 Chinese T2DM patients and 4,451 individuals from the National Health and Nutrition Examination Survey (NHANES) database. To evaluate the relationship between α-klotho levels and DKD risk, multivariate logistic regression was utilized. Additionally, restricted cubic spline (RCS) regression analysis was conducted to examine the nonlinear relationship between α-klotho levels and DKD incidence. RCS analysis was employed to explore the correlation between α-klotho and both all-cause and cardiovascular mortality. Results In the Chinese cohort, α-klotho levels were notably elevated in T2DM group compared to DKD group. The NHANES data revealed a significant inverse relationship between α-klotho levels and DKD risk. Nonlinear analysis further illustrated a substantial nonlinear connection between α-klotho levels and DKD risk. Serum α-klotho levels below 880.78 pg/mL were linked to increased DKD risk in T2DM patients. When compared to the T2DM group, the DKD group had markedly higher all-cause and cardiovascular mortality rates, with the α-klotho low group (e.g., Q1) exhibiting lower survival compared to other groups. Cox regression findings indicated that elevated α-klotho levels could mitigate all-cause mortality in T2DM patients. The relationship between α-klotho levels and all-cause mortality was also nonlinear, with the minimal risk found at α-klotho levels between 776.95 pg/mL and 812.69 pg/mL, varying by gender. Conclusion There exists a notable association between α-klotho levels and DKD risk, along with mortality in T2DM patients, with varying effects based on gender. These results highlight the potential importance of α-klotho as both a biomarker and a therapeutic target. |
| format | Article |
| id | doaj-art-86c097e80edb4be09f5efdb48bb4b4f4 |
| institution | OA Journals |
| issn | 1758-5996 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Diabetology & Metabolic Syndrome |
| spelling | doaj-art-86c097e80edb4be09f5efdb48bb4b4f42025-08-20T02:10:54ZengBMCDiabetology & Metabolic Syndrome1758-59962025-05-0117111410.1186/s13098-025-01711-xAssociation between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES databaseYi Kang0Qian Jin1Mengqi Zhou2Huijuan Zheng3Danwen Li4Jingwei Zhou5Jie Lv6Yaoxian Wang7Dongzhimen Hospital, Beijing University of Chinese MedicineGraduate School of Beijing, University of Chinese MedicineDepartment of Traditional Chinese Medicine, Beijing Puren HospitalDongzhimen Hospital, Beijing University of Chinese MedicineDongzhimen Hospital, Beijing University of Chinese MedicineDongzhimen Hospital, Beijing University of Chinese MedicineDongzhimen Hospital, Beijing University of Chinese MedicineDongzhimen Hospital, Beijing University of Chinese MedicineAbstract Background The α-klotho is crucial in diabetes and its related complications. This study seeks to explore the link between α-klotho levels and the risk of diabetic kidney disease (DKD) as well as all-cause and cardiovascular mortality among individuals with type 2 diabetes mellitus (T2DM). Methods The investigation involved 126 Chinese T2DM patients and 4,451 individuals from the National Health and Nutrition Examination Survey (NHANES) database. To evaluate the relationship between α-klotho levels and DKD risk, multivariate logistic regression was utilized. Additionally, restricted cubic spline (RCS) regression analysis was conducted to examine the nonlinear relationship between α-klotho levels and DKD incidence. RCS analysis was employed to explore the correlation between α-klotho and both all-cause and cardiovascular mortality. Results In the Chinese cohort, α-klotho levels were notably elevated in T2DM group compared to DKD group. The NHANES data revealed a significant inverse relationship between α-klotho levels and DKD risk. Nonlinear analysis further illustrated a substantial nonlinear connection between α-klotho levels and DKD risk. Serum α-klotho levels below 880.78 pg/mL were linked to increased DKD risk in T2DM patients. When compared to the T2DM group, the DKD group had markedly higher all-cause and cardiovascular mortality rates, with the α-klotho low group (e.g., Q1) exhibiting lower survival compared to other groups. Cox regression findings indicated that elevated α-klotho levels could mitigate all-cause mortality in T2DM patients. The relationship between α-klotho levels and all-cause mortality was also nonlinear, with the minimal risk found at α-klotho levels between 776.95 pg/mL and 812.69 pg/mL, varying by gender. Conclusion There exists a notable association between α-klotho levels and DKD risk, along with mortality in T2DM patients, with varying effects based on gender. These results highlight the potential importance of α-klotho as both a biomarker and a therapeutic target.https://doi.org/10.1186/s13098-025-01711-xα-klothoType 2 diabetesDiabetic kidney diseaseAll-cause mortalityCardiovascular mortality |
| spellingShingle | Yi Kang Qian Jin Mengqi Zhou Huijuan Zheng Danwen Li Jingwei Zhou Jie Lv Yaoxian Wang Association between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES database Diabetology & Metabolic Syndrome α-klotho Type 2 diabetes Diabetic kidney disease All-cause mortality Cardiovascular mortality |
| title | Association between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES database |
| title_full | Association between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES database |
| title_fullStr | Association between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES database |
| title_full_unstemmed | Association between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES database |
| title_short | Association between serum α-klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes: evidence from a Chinese cohort and the NHANES database |
| title_sort | association between serum α klotho levels and the incidence of diabetic kidney disease and mortality in type 2 diabetes evidence from a chinese cohort and the nhanes database |
| topic | α-klotho Type 2 diabetes Diabetic kidney disease All-cause mortality Cardiovascular mortality |
| url | https://doi.org/10.1186/s13098-025-01711-x |
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