Peilin Zou, Jiajun Li, Liangkai Chen, Man Liu, Hao Nie, Jinhua Yan, Le Zhang, Hongyu Gao, Cuntai Zhang, Yucong Zhang
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The associations between exposure factors and CKD prevalence were assessed via a logistic regression model. Subgroup analysis was performed for each confounding factor to assess the robustness of the results.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>This study enrolled 13,273 participants, 3859 of whom were CKD patients. CKD patients had higher ePWV (9.66 ± 1.75 m/s vs. 8.48 ± 1.64 m/s, <i>p</i> < 0.001) and lower levels of serum Klotho (816.35 ± 290.47 pg/mL vs. 869.87 ± 315.87 pg/mL, <i>p</i> < 0.001). A significant negative linear association was found between ePWV and serum Klotho. According to the fully adjusted model, a significant interaction effect between ePWV and serum Klotho was observed on the risk of CKD (<i>p</i> < 0.001). Compared with individuals with a lower ePWV and higher serum Klotho, individuals with an increased ePWV and lower serum Klotho had a significantly elevated risk of CKD (OR: 1.847, 95% confidence interval: 1.467–2.325; <i>p</i> < 0.001). The subgroup analysis revealed that the results were robust.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The study demonstrated significant interaction effect of ePWV and serum Klotho on the prevalence of CKD. Individuals with increased ePWV and decreased serum Klotho levels had the highest risk of CKD. The assessment of the combination of ePWV and serum Klotho for CKD management should be considered routine in clinical practice.</p>\n </section>\n </div>","PeriodicalId":32862,"journal":{"name":"Aging Medicine","volume":"8 1","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/agm2.70005","citationCount":"0","resultStr":"{\"title\":\"Interaction Effect of Estimated Pulse Wave Velocity and Serum Klotho Level on Chronic Kidney Disease\",\"authors\":\"Peilin Zou, Jiajun Li, Liangkai Chen, Man Liu, Hao Nie, Jinhua Yan, Le Zhang, Hongyu Gao, Cuntai Zhang, Yucong Zhang\",\"doi\":\"10.1002/agm2.70005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>Older individuals usually have greater arterial stiffness, lower serum Klotho levels and a greater incidence of chronic kidney disease (CKD). The current study aimed to evaluate the interaction effect of estimated pulse wave velocity (ePWV) and serum Klotho levels on CKD in Americans.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Data from the National Health and Nutrition Examination Survey database from 2007 to 2016 were used. Participants with data for the assessment of ePWV and serum Klotho and for the assessment of CKD were enrolled. The associations between ePWV and serum Klotho levels were analyzed via restricted cubic spline analysis and a linear regression model. The associations between exposure factors and CKD prevalence were assessed via a logistic regression model. Subgroup analysis was performed for each confounding factor to assess the robustness of the results.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>This study enrolled 13,273 participants, 3859 of whom were CKD patients. CKD patients had higher ePWV (9.66 ± 1.75 m/s vs. 8.48 ± 1.64 m/s, <i>p</i> < 0.001) and lower levels of serum Klotho (816.35 ± 290.47 pg/mL vs. 869.87 ± 315.87 pg/mL, <i>p</i> < 0.001). A significant negative linear association was found between ePWV and serum Klotho. According to the fully adjusted model, a significant interaction effect between ePWV and serum Klotho was observed on the risk of CKD (<i>p</i> < 0.001). Compared with individuals with a lower ePWV and higher serum Klotho, individuals with an increased ePWV and lower serum Klotho had a significantly elevated risk of CKD (OR: 1.847, 95% confidence interval: 1.467–2.325; <i>p</i> < 0.001). The subgroup analysis revealed that the results were robust.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The study demonstrated significant interaction effect of ePWV and serum Klotho on the prevalence of CKD. Individuals with increased ePWV and decreased serum Klotho levels had the highest risk of CKD. 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引用次数: 0
摘要
老年人通常有较大的动脉僵硬，较低的血清Klotho水平和较高的慢性肾脏疾病（CKD）发病率。目前的研究旨在评估估计脉搏波速度（ePWV）和血清Klotho水平对美国人CKD的相互作用。方法使用2007 - 2016年全国健康与营养检查调查数据库中的数据。纳入具有ePWV和血清Klotho评估数据以及CKD评估数据的参与者。通过限制三次样条分析和线性回归模型分析ePWV与血清Klotho水平的关系。通过logistic回归模型评估暴露因素与慢性肾病患病率之间的关系。对每个混杂因素进行亚组分析，以评估结果的稳健性。该研究共招募了13273名参与者，其中3859名是CKD患者。CKD患者ePWV较高（9.66±1.75 m/s vs 8.48±1.64 m/s, p < 0.001），血清Klotho水平较低（816.35±290.47 pg/mL vs 869.87±315.87 pg/mL, p < 0.001）。ePWV与血清Klotho呈显著负线性相关。根据完全调整后的模型，ePWV和血清Klotho对CKD的风险有显著的交互作用（p < 0.001）。与ePWV升高、Klotho升高的个体相比，ePWV升高、Klotho降低的个体发生CKD的风险显著升高(OR: 1.847, 95%可信区间：1.467-2.325；p < 0.001)。亚组分析显示结果是稳健的。结论ePWV与血清Klotho对CKD患病率有显著交互作用。ePWV升高和血清Klotho水平降低的个体患CKD的风险最高。在临床实践中，联合评估ePWV和血清Klotho对CKD的治疗应被视为常规。
Interaction Effect of Estimated Pulse Wave Velocity and Serum Klotho Level on Chronic Kidney Disease
Objectives
Older individuals usually have greater arterial stiffness, lower serum Klotho levels and a greater incidence of chronic kidney disease (CKD). The current study aimed to evaluate the interaction effect of estimated pulse wave velocity (ePWV) and serum Klotho levels on CKD in Americans.
Methods
Data from the National Health and Nutrition Examination Survey database from 2007 to 2016 were used. Participants with data for the assessment of ePWV and serum Klotho and for the assessment of CKD were enrolled. The associations between ePWV and serum Klotho levels were analyzed via restricted cubic spline analysis and a linear regression model. The associations between exposure factors and CKD prevalence were assessed via a logistic regression model. Subgroup analysis was performed for each confounding factor to assess the robustness of the results.
Results
This study enrolled 13,273 participants, 3859 of whom were CKD patients. CKD patients had higher ePWV (9.66 ± 1.75 m/s vs. 8.48 ± 1.64 m/s, p < 0.001) and lower levels of serum Klotho (816.35 ± 290.47 pg/mL vs. 869.87 ± 315.87 pg/mL, p < 0.001). A significant negative linear association was found between ePWV and serum Klotho. According to the fully adjusted model, a significant interaction effect between ePWV and serum Klotho was observed on the risk of CKD (p < 0.001). Compared with individuals with a lower ePWV and higher serum Klotho, individuals with an increased ePWV and lower serum Klotho had a significantly elevated risk of CKD (OR: 1.847, 95% confidence interval: 1.467–2.325; p < 0.001). The subgroup analysis revealed that the results were robust.
Conclusions
The study demonstrated significant interaction effect of ePWV and serum Klotho on the prevalence of CKD. Individuals with increased ePWV and decreased serum Klotho levels had the highest risk of CKD. The assessment of the combination of ePWV and serum Klotho for CKD management should be considered routine in clinical practice.
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