Circulating Klotho levels can predict long-term macrovascular outcomes in type 2 diabetic patients

Pan, Heng‐Chih; Chou, Kuei-Mei; Lee, Chin‐Chan; Yang, Ning-I; Sun, Chiao‐Yin

doi:10.1016/j.atherosclerosis.2018.07.006

Cited by 40 publications

(37 citation statements)

References 49 publications

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“…Interestingly, several studies have pointed out a relationship between the decrease in serum soluble Klotho and worse outcomes in vascular functional tests, like reduced capacity of flow-mediated dilation of the brachial artery, or higher values of epicardial fat thickness and carotid artery intima-media thickness (cIMT) in healthy adults [8], or increased ankle-brachial pulse wave velocity, left ventricular mass index, cIMT and carotid atherosclerotic plaque quantity in chronic kidney disease population [5][6][7]. Furthermore, Pan et al recently showed, in a prospective study of 252 patients and a 7-year follow-up, that lower baseline levels of circulating Klotho were associated with an increased risk of developing CAD or cerebrovascular accident (CVA) in the long term in diabetic population [13].…”

Section: Discussionmentioning

confidence: 99%

“…Aging is associated with a reduction in the renal expression and serum concentrations of Klotho, which is also observed in diseases characterized by premature vascular aging, such as renal failure, hypertension, and diabetes mellitus [4][5][6]. Moreover, several clinical studies have observed that lower systemic levels of the soluble form of Klotho are associated with markers of vascular dysfunction [7][8][9][10] as well as with the prevalence and severity of cardiovascular disease (CVD) [11][12][13]. These associations are particularly relevant in renal patients since the largest proportion of systemic Klotho is generated by the kidneys and its levels are reduced along with the renal function decline [14].…”

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confidence: 99%

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Association between serum levels of Klotho and inflammatory cytokines in cardiovascular disease: a case-control study

Martín‐Núñez

Donate‐Correa

Ferri

et al. 2020

Aging

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INTRODUCTION Klotho (KL) is a longevity-related gene discovered in 1997 [1]. Defects in KL expression leads to a syndrome resembling human aging that includes endothelial dysfunction, vascular calcification and progressive atherosclerosis [1]. KL gene encodes a single-pass transmembrane glycoprotein type 1, mainly expressed in renal tubular cells, and a soluble form derived from the action of membrane proteases that cleave the extracellular domain of the membranebound protein [2, 3].

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Association between serum levels of Klotho and inflammatory cytokines in cardiovascular disease: a case-control study

Martín‐Núñez

Donate‐Correa

Ferri

et al. 2020

Aging

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“…In fact, activation of NF-κB is implicated in pathological inflammation, promoting the transcription of pro-inflammatory cytokines, such as TNF-α and IL-6, which are involved in the progression of coronary atherosclerosis [36]. Finally, VitD can exert its beneficial effects via Klotho, one of its target genes that has been associated with longevity and whose protective effects against macrovascular complications of type 2 Diabetes were recently described [49]. Klotho is a transmembrane protein mainly expressed in the kidneys, whose extracellular domain can be cleaved to generate a soluble Klotho ectodomain [50].…”

Section: Discussionmentioning

confidence: 99%

“…Finally, VitD can exert its beneficial effects via Klotho, one of its target genes that has been associated with longevity and whose protective effects against macrovascular complications of type 2 Diabetes were recently described [ 49 ]. Klotho is a transmembrane protein mainly expressed in the kidneys, whose extracellular domain can be cleaved to generate a soluble Klotho ectodomain [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Diabetes Mellitus and Vitamin D Deficiency: Comparable Effect on Survival and a Deadly Association after a Myocardial Infarction

Aleksova

Ferro

Gagno

et al. 2020

JCM

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Survivors after a myocardial infarction (MI), especially those with diabetes mellitus (DM), remain at high risk of further events. Identifying and treating factors that may influence survival may open new therapeutic strategies. We assessed the impact on prognosis of DM and hypovitaminosis D (hypovitD), alone or combined. In this prospective, observational study, 1081 patients were enrolled surviving an MI and divided into four groups according to their diabetic and VitD status. The primary end-point was composite of all-cause mortality, angina/MI and heart failure (HF). Secondary outcomes were mortality, HF and angina/MI. During a follow-up of 26.1 months (IQR 6.6–64.5), 391 subjects experienced the primary end-point. Patients with DM or hypovitD had similar rate of the composite end-point. Patients with only hypovitD or DM did not differ regarding components of composite end-point (angina p = 0.97, HF p = 0.29, mortality p = 0.62). DM and VitD deficiency had similarly adjusted risks for primary end-point (HR 1.3, 95%CI 1.05–1.61; HR 1.3, 95% CI 1.04–1.64). The adjusted HR for primary composite end-point for patients with hypovitD and DM was 1.69 (95%CI 1.25–2.29, p = 0.001) in comparison to patients with neither hypoD nor DM. In conclusion, DM and hypovitD, individually and synergistically, are associated with a worse outcome after MI.

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“…No estudo realizado em 2012 por Elliot e colaboradores, foi demonstrado que a complexidade de tratamento em idoso dificulta a compreensão, o que reflete na adesão ao tratamento. Foi observado então maior relato de falha na adesão ao tratamento no período anterior à internação (44,4%), podendo ter como suspeita que compreensão e adesão interfiram no desenvolvimento de complicações da doença e na ocorrência da hospitalização 23 .…”

Section: Discussionunclassified

Characterization of patients using insulin in a pharmacotherapeutic service and identification of hospital readmissions

Malta¹,

Costa²,

Machado³

et al. 2020

Rev Bras Farm Hosp Serv Saude

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Objective: To characterize patients with insulin-dependent Diabetes Mellitus (DM) accompanied by a PF service in a teaching hospital, as well as to identify the occurrence of hospital readmissions and associated factors. Methods: This is a cross-sectional study carried out in a general teaching hospital, being included patients above 18 years old, of both genders, with type 1 or 2 DM diagnosis were admitted from April 2015 to April 2016, accompanied by the Pharmaceutical Follow-up Service of the hospital, who used insulin during hospitalization and received indication for using this drug in the hospital discharge prescription. Data were collected through consultation in electronic medical records and telephone contact after the hospital discharge. Data were recorded in a Microsoft Excel spreadsheet, with the patients subdivided into groups with and without readmission, followed by univariate analysis of associated factors by means of proportion comparison and logistic model with penalized likelihood. Results: Patients who were re-admitted had higher blood sugar values, fewer pharmaceutical interventions regarding insulin use, and longer average hospitalization time. The analysis of the association between variables and readmission did not present statistical significance. Conclusions: The study points out to weaknesses related to the offer of care to the patients under study, such as weaknesses in the coverage for offering actions related to health education in the periods before and after hospital discharge, difficulty in accessing the specialist physician and non-achievement of blood sugar measurement by some patients. There was no association between any of the analyzed variables and hospital readmission.

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Circulating Klotho levels can predict long-term macrovascular outcomes in type 2 diabetic patients

Abstract: Our results suggest that circulating Klotho level is a predictor of long-term macrovascular outcomes in patients with type 2 diabetes.

Cited by 40 publications

References 49 publications

Association between serum levels of Klotho and inflammatory cytokines in cardiovascular disease: a case-control study

Association between serum levels of Klotho and inflammatory cytokines in cardiovascular disease: a case-control study

Diabetes Mellitus and Vitamin D Deficiency: Comparable Effect on Survival and a Deadly Association after a Myocardial Infarction

Characterization of patients using insulin in a pharmacotherapeutic service and identification of hospital readmissions

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