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Klotho levels: association with insulin resistance and albumin-to-creatinine ratio in type 2 diabetic patients

  • Nephrology - Original Paper
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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.

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Authors and Affiliations

  1. Department of Nephrology, Centro Hospitalar do Algarve, Faro, Portugal

    Ana Paula Silva, Filipa Mendes, Luísa Pereira, André Fragoso & Pedro Leão Neves

  2. Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal

    Ana Paula Silva, Rui Baptista Gonçalves & Pedro Leão Neves

  3. Pathology Clinic, Centro Hospitalar do Algarve, Faro, Portugal

    Nélio Santos & Fátima Rato

Authors
  1. Ana Paula Silva
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  2. Filipa Mendes
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  3. Luísa Pereira
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  4. André Fragoso
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  5. Rui Baptista Gonçalves
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  6. Nélio Santos
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  7. Fátima Rato
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  8. Pedro Leão Neves
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Corresponding author

Correspondence to Ana Paula Silva.

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The authors declare that they have no conflict of interest.

Ethical approval

All performed procedures were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Silva, A.P., Mendes, F., Pereira, L. et al. Klotho levels: association with insulin resistance and albumin-to-creatinine ratio in type 2 diabetic patients. Int Urol Nephrol 49, 1809–1814 (2017). https://doi.org/10.1007/s11255-017-1646-3

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  • DOI: https://doi.org/10.1007/s11255-017-1646-3

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