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Abstract：
OBJECTIVE: To investigate the potential linear relationship between serum concentrations of klotho and frailty.
METHODS: A retrospective analysis was conducted on the data of 9,597 middle-aged and older adults (aged 40-79 years) from the five cycles of the National Health and Nutrition Examination Survey (NHANES). Frailty was assessed using the Frailty Index, calculated as a percentage of accumulated deficits across 53 health items. Restricted cubic spline curves, subgroup analyses and logistic regression models were employed to evaluate the specific linear trend connection between circulating klotho protein concentration and frailty.
RESULTS: When taking Klotho into account as a continuous component in Models 1 and 2, there was a substantial association between the increasing Klotho level and the reduced risk of frailty. Model 3 revealed a strong negative correlation between the Klotho and Frailty, suggesting that high levels of Klotho protein decreases the frailty prevalence [Odd ratio (OR): 0.25; 95% confidence interval (CI): 0.15-0.43]. Furthermore, according to the quartile analyses, after fully adjusting for the covariates, it was observed that, comparing to the lowest quartile of Klotho, the highest quartile of Klotho demonstrated lowest risk of frailty (OR 0.69; 95% CI 0.58-0.81, Ptrend < 0.001). The restricted cubic spline curves showed a linear relationship and an inverse association between frailty and the Klotho levels (Plinearity < 0.001; Pnon-linearity = 0.736).
CONCLUSIONS: Klotho is inversely and linearly associated with physical frailty in the general population (aged 40-79 years), specifically in the population with an age < 65 and body mass index (BMI) ≥ 25 kg/m2. More necessary prospective studies should be done to further investigate the mechanisms underlying frailty and aging and to elucidate individual frailty causes.
METHODS: A retrospective analysis was conducted on the data of 9,597 middle-aged and older adults (aged 40-79 years) from the five cycles of the National Health and Nutrition Examination Survey (NHANES). Frailty was assessed using the Frailty Index, calculated as a percentage of accumulated deficits across 53 health items. Restricted cubic spline curves, subgroup analyses and logistic regression models were employed to evaluate the specific linear trend connection between circulating klotho protein concentration and frailty.
RESULTS: When taking Klotho into account as a continuous component in Models 1 and 2, there was a substantial association between the increasing Klotho level and the reduced risk of frailty. Model 3 revealed a strong negative correlation between the Klotho and Frailty, suggesting that high levels of Klotho protein decreases the frailty prevalence [Odd ratio (OR): 0.25; 95% confidence interval (CI): 0.15-0.43]. Furthermore, according to the quartile analyses, after fully adjusting for the covariates, it was observed that, comparing to the lowest quartile of Klotho, the highest quartile of Klotho demonstrated lowest risk of frailty (OR 0.69; 95% CI 0.58-0.81, Ptrend < 0.001). The restricted cubic spline curves showed a linear relationship and an inverse association between frailty and the Klotho levels (Plinearity < 0.001; Pnon-linearity = 0.736).
CONCLUSIONS: Klotho is inversely and linearly associated with physical frailty in the general population (aged 40-79 years), specifically in the population with an age < 65 and body mass index (BMI) ≥ 25 kg/m2. More necessary prospective studies should be done to further investigate the mechanisms underlying frailty and aging and to elucidate individual frailty causes.
摘要：
目的：研究血清klotho浓度与虚弱之间的潜在线性关系。
方法：对全国健康与营养调查（NHANES）五个周期的9,597名中老年人（40-79岁）的数据进行回顾性分析。使用脆弱指数评估脆弱，以53项健康项目累计赤字的百分比计算。受限制的三次样条曲线，亚组分析和逻辑回归模型用于评估循环klotho蛋白浓度与虚弱之间的特定线性趋势关系.
结果：当将Klotho作为模型1和模型2中的连续成分考虑在内时，增加的Klotho水平与降低的虚弱风险之间存在实质性关联。模型3显示了Klotho和Failty之间的强烈负相关，表明高水平的Klotho蛋白降低了虚弱患病率[奇数比(OR):0.25;95%置信区间(CI):0.15-0.43].此外，根据四分位数分析，在完全调整协变量后，据观察，与Klotho的最低四分位数相比，Klotho的最高四分位数表现出最低的虚弱风险(OR0.69;95%CI0.58-0.81,Ptrend<0.001).受限的三次样条曲线显示出脆弱与Klotho水平之间的线性关系和逆关联（Plinearity<0.001；Pnon-linearity=0.736）。
结论：Klotho与一般人群（40-79岁）的身体虚弱呈负相关和线性相关，特别是在年龄<65且体重指数（BMI）≥25kg/m2的人群中。应进行更多必要的前瞻性研究，以进一步研究虚弱和衰老的潜在机制，并阐明个体虚弱的原因。
方法：对全国健康与营养调查（NHANES）五个周期的9,597名中老年人（40-79岁）的数据进行回顾性分析。使用脆弱指数评估脆弱，以53项健康项目累计赤字的百分比计算。受限制的三次样条曲线，亚组分析和逻辑回归模型用于评估循环klotho蛋白浓度与虚弱之间的特定线性趋势关系.
结果：当将Klotho作为模型1和模型2中的连续成分考虑在内时，增加的Klotho水平与降低的虚弱风险之间存在实质性关联。模型3显示了Klotho和Failty之间的强烈负相关，表明高水平的Klotho蛋白降低了虚弱患病率[奇数比(OR):0.25;95%置信区间(CI):0.15-0.43].此外，根据四分位数分析，在完全调整协变量后，据观察，与Klotho的最低四分位数相比，Klotho的最高四分位数表现出最低的虚弱风险(OR0.69;95%CI0.58-0.81,Ptrend<0.001).受限的三次样条曲线显示出脆弱与Klotho水平之间的线性关系和逆关联（Plinearity<0.001；Pnon-linearity=0.736）。
结论：Klotho与一般人群（40-79岁）的身体虚弱呈负相关和线性相关，特别是在年龄<65且体重指数（BMI）≥25kg/m2的人群中。应进行更多必要的前瞻性研究，以进一步研究虚弱和衰老的潜在机制，并阐明个体虚弱的原因。
