Association of serum klotho levels with chronic kidney disease and mortality in patients with type 2 diabetes: evidence from Chinese cohort and NHANES databases

Yi Kang; Qian Jin; Mengqi Zhou; Huijuan Zheng; Jinwei Zhou; Danwen Li; Jie Lv; Yao Wang

doi:10.1530/endoabs.109.P96

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Endocrine Abstracts (2025) 109 P96 | DOI: 10.1530/endoabs.109.P96

SFEBES2025 Poster Presentations Metabolism, Obesity and Diabetes (68 abstracts)

Association of serum klotho levels with chronic kidney disease and mortality in patients with type 2 diabetes: evidence from Chinese cohort and NHANES databases

Yi Kang ¹ , Qian Jin ² , Mengqi Zhou ³ , Huijuan Zheng ¹ , Jinwei Zhou ¹ , Danwen Li ¹ , Jie Lv ¹ & Yao Wang ¹

Author affiliations

¹Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China; ²Beijing University of Chinese Medicine, Beijing, China; ³Beijing Puren Hospital, Beijing, China

Background: The klotho is crucial in diabetes and its related complications. This study seeks to explore the link between klotho levels and the risk of chronic kidney disease (CKD) 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 NHANES database. To evaluate the relationship between klotho levels and CKD risk, multivariate logistic regression was utilized. Additionally, restricted cubic spline (RCS) regression analysis was conducted to examine the nonlinear relationship between klotho levels and CKD incidence. RCS Cox regression was employed to analyze the correlation between klotho and both all-cause and cardiovascular mortality.

Results: In the Chinese cohort, klotho levels were notably elevated in T2DM patients without CKD compared to those with CKD. The NHANES data revealed a significant inverse relationship between klotho levels and diabetic kidney disease (DKD) risk, especially in patients with elevated klotho levels, where the likelihood of DKD was markedly diminished. Nonlinear analysis further illustrated a substantial nonlinear connection between klotho levels and DKD risk; serum klotho levels below 880.78 pg/ml were linked to increased CKD risk in T2DM patients, showing significant gender disparities. When compared to the T2DM group, the DKD group had markedly higher all-cause and cardiovascular mortality rates. Cox regression findings indicated that elevated klotho levels could mitigate all-cause mortality in T2DM patients. The relationship between klotho levels and all-cause mortality was also nonlinear, with the minimal risk found at klotho levels between 776.95 pg/mL and 812.69 pg/mL, varying by gender.

Conclusion: There exists a notable association between klotho levels and CKD risk, along with mortality in T2DM patients, with varying effects based on gender. These results highlight the potential importance of klotho as both a biomarker and a therapeutic target.