Ana Paula Silva1,2, Filipa Mendes3, Luísa Pereira3, André Fragoso3, Rui Baptista Gonçalves4, Nélio Santos5, Fátima Rato5, Pedro Leão Neves3,4. 1. Department of Nephrology, Centro Hospitalar do Algarve, Faro, Portugal. anapassionara@gmail.com. 2. Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal. anapassionara@gmail.com. 3. Department of Nephrology, Centro Hospitalar do Algarve, Faro, Portugal. 4. Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal. 5. Pathology Clinic, Centro Hospitalar do Algarve, Faro, Portugal.
Abstract
PURPOSE: The present study aimed at evaluating the relationship between Klotho levels and insulin resistance and albumin-to-creatinine ratio (ACR) in type 2 diabetic patients with CKD. METHODS: We conducted an observational, cross-sectional study in our outpatient diabetic nephropathy clinic from 2014 to 2016, enrolling a total of 107 type 2 diabetic patients with stage 2-3 CKD, with a mean age of 59 years. Several clinical and laboratorial parameters were evaluated, including those related to mineral and carbohydrate metabolism. RESULTS: The mean eGFR at baseline was 53.2 mL/min, and the mean levels of ACR and Klotho were 181.9 µg/mg and 331.1 pg/m, respectively. In the simple linear regression model, Klotho levels were correlated with age, phosphorus, PTH, ACR, HOMA, IL-6, FGF-23, OxLDL, eGFR and vitamin D levels. Applying a multivariate linear regression model, only the ACR, HOMA-IR, FGF-23 and vitamin D independently influenced the Klotho levels. In the generalized linear model, only the Klotho groups were statistically significant as independent variable (p = 0.007). The results show that the group 1 (<268) compared with group 3 (>440) had higher odds in the higher ACR (≥181), ORa = 3.429, p = 0.014. There were no statistically significant differences between Klotho groups 2 and 3, and the HOMA-IR obtained showed that group 1 (<268) had greater odds of HOMA-IR ≥2 when compared with group 3 (>440), ORa = 21.59, p = 0.017. CONCLUSIONS: Our results showed that Klotho levels are influenced by FGF23, vitamin D and insulin resistance. This suggests that Klotho levels might be affected by renal function as well as having a relevant role on insulin metabolism and ACR homeostasis.
PURPOSE: The present study aimed at evaluating the relationship between Klotho levels and insulin resistance and albumin-to-creatinine ratio (ACR) in type 2 diabeticpatients with CKD. METHODS: We conducted an observational, cross-sectional study in our outpatientdiabetic nephropathy clinic from 2014 to 2016, enrolling a total of 107 type 2 diabeticpatients with stage 2-3 CKD, with a mean age of 59 years. Several clinical and laboratorial parameters were evaluated, including those related to mineral and carbohydrate metabolism. RESULTS: The mean eGFR at baseline was 53.2 mL/min, and the mean levels of ACR and Klotho were 181.9 µg/mg and 331.1 pg/m, respectively. In the simple linear regression model, Klotho levels were correlated with age, phosphorus, PTH, ACR, HOMA, IL-6, FGF-23, OxLDL, eGFR and vitamin D levels. Applying a multivariate linear regression model, only the ACR, HOMA-IR, FGF-23 and vitamin D independently influenced the Klotho levels. In the generalized linear model, only the Klotho groups were statistically significant as independent variable (p = 0.007). The results show that the group 1 (<268) compared with group 3 (>440) had higher odds in the higher ACR (≥181), ORa = 3.429, p = 0.014. There were no statistically significant differences between Klotho groups 2 and 3, and the HOMA-IR obtained showed that group 1 (<268) had greater odds of HOMA-IR ≥2 when compared with group 3 (>440), ORa = 21.59, p = 0.017. CONCLUSIONS: Our results showed that Klotho levels are influenced by FGF23, vitamin D and insulin resistance. This suggests that Klotho levels might be affected by renal function as well as having a relevant role on insulin metabolism and ACR homeostasis.
Entities:
Keywords:
Chronic kidney disease; Diabetes; Klotho; Mineral metabolism
Authors: Dick de Zeeuw; Rajiv Agarwal; Michael Amdahl; Paul Audhya; Daniel Coyne; Tushar Garimella; Hans-Henrik Parving; Yili Pritchett; Giuseppe Remuzzi; Eberhard Ritz; Dennis Andress Journal: Lancet Date: 2010-11-06 Impact factor: 79.321
Authors: N Koh; T Fujimori; S Nishiguchi; A Tamori; S Shiomi; T Nakatani; K Sugimura; T Kishimoto; S Kinoshita; T Kuroki; Y Nabeshima Journal: Biochem Biophys Res Commun Date: 2001-02-02 Impact factor: 3.575
Authors: Juan A Moreno; Maria C Izquierdo; Maria D Sanchez-Niño; Beatriz Suárez-Alvarez; Carlos Lopez-Larrea; Aniela Jakubowski; Julia Blanco; Rafael Ramirez; Rafael Selgas; Marta Ruiz-Ortega; Jesus Egido; Alberto Ortiz; Ana B Sanz Journal: J Am Soc Nephrol Date: 2011-06-30 Impact factor: 10.121
Authors: Andrew S Levey; Lesley A Stevens; Christopher H Schmid; Yaping Lucy Zhang; Alejandro F Castro; Harold I Feldman; John W Kusek; Paul Eggers; Frederick Van Lente; Tom Greene; Josef Coresh Journal: Ann Intern Med Date: 2009-05-05 Impact factor: 25.391
Authors: Carmen Hurtado Del Pozo; Elena Garreta; Juan Carlos Izpisúa Belmonte; Nuria Montserrat Journal: Dis Model Mech Date: 2018-11-20 Impact factor: 5.758
Authors: Francisco J Amaro-Gahete; Lucas Jurado-Fasoli; Guillermo Sanchez-Delgado; José V García-Lario; Manuel J Castillo; Jonatan R Ruiz Journal: Aging (Albany NY) Date: 2020-01-20 Impact factor: 5.682