Serum Klotho Modifies the Associations of 25-Hydroxy Vitamin D With All-Cause and Cardiovascular Mortality
Authors' conclusion
Vitamin D-associated mortality risk is observed only with concurrently decreasing klotho, indicating that vitamin D metabolism dysfunction increases the risk of mortality. Klotho levels could help predict long-term mortality outcomes and thus may be useful concurrently for guiding vitamin D supplementation therapy decision-making in populations with vitamin D deficiency.
Study context
- Population
- American community-dwelling adults, NHANES 2007–2016
- Participants
- 9,870 adults
- Exposure
- Joint association of serum 25D and klotho with mortality
- Outcome
- All-cause and CVD mortality
Methodological detailsNHANES 2007-2016, linked to National Death Index, Cox proportional hazards models
- NHANES 2007-2016
- Linked to National Death Index
- Cox proportional hazards models
Main finding
As reported in the abstract
Interaction of klotho and serum 25(OH)D on all-cause and CVD mortality
- Interaction between klotho and serum 25(OH)D in all-cause mortality
- P = .028
- Klotho < 848.4 pg/mL, serum 25(OH)D < 50 nmol/L: all-cause mortality HR
- 1.36 (1.10-1.69) (95% CI)
- Klotho < 848.4 pg/mL, serum 25(OH)D < 50 nmol/L: Cardiovascular disease (CVD) mortality HR
- 1.78 (1.16-3.45) (95% CI)
- Klotho < 848.4 pg/mL, continuous serum 25(OH)D: all-cause mortality HR
- 0.98 (.97-.99) (95% CI)
- Klotho < 848.4 pg/mL, continuous serum 25(OH)D: CVD mortality HR
- 0.98 (.98-.99) (95% CI)
Observational data: associations, not effects.
Further findings
Combined serum 25(OH)D <50 nmol/L and klotho <848.4 pg/mL (vitamin D metabolism disruption)
- All-cause mortality HR
- 1.48 (1.11-1.96) (95% CI)
- CVD mortality HR
- 2.36 (1.48-3.75) (95% CI)
Original publication
Serum Klotho Modifies the Associations of 25-Hydroxy Vitamin D With All-Cause and Cardiovascular Mortality. J Clin Endocrinol Metab. Published 15 August 2023. doi:10.
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