The following is a summary of “Serum Klotho Modifies the Association of 25-Hydroxyvitamin D with All-Cause and Cardiovascular Mortality” published in the February 2024 issue. endocrinology According to Chen et al.
The relationship between 25-hydroxyvitamin D and mortality remains controversial. Klotho, a biomarker of vitamin D activation and metabolism, may influence this association. However, it was unclear whether Klotho levels influence the association between vitamin D deficiency and mortality. For the study, researchers sought to investigate the joint effects of serum 25-hydroxyvitamin D. [25(OH)D] And klotho studied the risk of death among American adults living in the community.
The study included 9,870 adults from the National Health and Nutrition Examination Survey (2007-2016). Mortality data were collected by linking participants to National Death Index records. Cox proportional hazards models were utilized to examine the relationship between serum 25(OH)D, serum klotho, all-cause mortality, and cardiovascular disease (CVD) mortality.
A significant interaction between klotho and serum 25(OH)D was observed on all-cause mortality (P = .028). No significant risk of all-cause or CVD mortality was detected at any serum 25(OH)D level when klotho levels were >848.4 pg/mL (mortality risk threshold). However, significant risks of all-cause and CVD mortality were observed for serum 25(OH)D < 50 nmol/L when klotho levels were <848.4 pg/mL[hazardratio(HR)13695%confidenceinterval(CI)110-169;HR17895%CI116-345)andasacontinuousvariable(HR09895%CI97-99;HR09895%CI98-99)AdditionallyimpairedmultivitaminDmetabolismindicatedbydecreasedserum25(OH)D(<50nmol/L)andklotho(<8484pg/mL)wasassociatedwithsignificantall-causemortality(HR14895%CI111)-196)andCVDmortality(HR23695%CI148-375)[hazardratio(HR)13695%confidenceinterval(CI)110-169;HR17895%CI116-345)andasacontinuousvariable(HR09895%CI97-99;HR09895%CI98-99)AdditionallycombinedvitaminDmetabolismdisruptionindicatedbydecreasedserum25(OH)D(<50nmol/L)andklotho(<8484pg/mL)wasassociatedwithsignificantall-causemortality(HR14895%CI111-196)andCVDmortality(HR23695%CI148-375)[ハザード比(HR)136、95%信頼区間(CI)110-169;HR178、95%CI116-345）および連続変数として（HR098、95%CI97-99;HR098、95%CI98-99）。さらに、血清25(OH)D(<50nmol/L)およびクロトー(<8484pg/mL)の減少によって示される複合ビタミンD代謝障害は、有意な全死因死亡率と関連していました(HR148、95%CI111)-196）およびCVD死亡率（HR236、95%CI148-375）。[hazardratio(HR)13695%confidenceinterval(CI)110-169;HR17895%CI116-345)andasacontinuousvariable(HR09895%CI97-99;HR09895%CI98-99)AdditionallycombinedvitaminDmetabolismdisruptionindicatedbydecreasedserum25(OH)D(<50nmol/L)andklotho(<8484pg/mL)wasassociatedwithsignificantall-causemortality(HR14895%CI111-196)andCVDmortality(HR23695%CI148-375)
The mortality risk associated with vitamin D was only apparent when Klotho levels were simultaneously reduced, suggesting that vitamin D metabolic dysfunction increases mortality risk. Klotho levels may serve as a predictive marker of long-term mortality and may guide decisions regarding vitamin D supplementation therapy in vitamin D-deficient populations.
reference: Academic.oup.com/jcem/article-abstract/109/2/581/7242539
