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Soluble alpha klotho - impact of biological variables and reference intervals for adults.
Eur. J. Endocrinol. 192, 631-640 (2025)
OBJECTIVE: Concentrations of soluble alpha klotho (sαKL) are higher in active acromegaly compared to healthy controls. However, reference intervals based on large population-based samples are lacking, and the impact of many biological variables is unclear. DESIGN: Cross-sectional study. METHODS: We measured sαKL concentrations in samples from an adult population (20-89 years, 435 males, 455 females). Associations with sex, age, body mass index, waist-hip-ratio, estimated glomerular filtration rate (eGFR), IGF-I and IGFBP 3, glucose-, lipid-, calcium- and liver-metabolism, fasting, and estrogen status were analyzed. Reference intervals were calculated using LMS quantile regression with a Box-Cox transformation to normality. We also analyzed sαKL in patients with non-functioning pituitary adenoma (NFPA, n=18) and prolactinoma (n=65). RESULTS: Across all ages, sαKL concentrations (pg/mL, median (IQR)) were slightly, but significantly higher in females compared to males (678 (537-859) vs. 651 (537-812), p=0.01), suggesting an impact of estrogens. SαKL exhibited a weak negative correlation with age, and positive correlations with eGFR and IGF-I (p<0.001 for both). Correlations to other biological factors including glucose, liver and calcium metabolism and duration of fasting were negligible (p>0.05 for all). Compared to sαKL, IGF-I more often was correlated significantly to other biological variables. SαKL was not different in patients with NFPA, but slightly higher in patients with prolactinoma (p<0.05). CONCLUSION: Our findings suggest sαKL is a stable GH-sensitive biomarker, that may be less impacted by biological variables compared to IGF-I and IGFBP 3. Our reference intervals will facilitate the potential use of sαKL in GH-related diseases.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Acromegaly ; Biomarker ; Growth Hormone ; Population-based Study; Growth-factor-i; Plasma Klotho; Serum Klotho; Igf-i; Anorexia-nervosa; Hormone; Interference; Disease; Fgf23; Axis
ISSN (print) / ISBN
0804-4643
e-ISSN
1479-683X
Quellenangaben
Volume: 192,
Issue: 5,
Pages: 631-640
Publisher
BioScientifica
Publishing Place
Great Clarendon St, Oxford Ox2 6dp, England
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology (EPI)
Grants
German Federal Ministry of Education and Research (BMBF) as part of the "Health in old age" program
State of Bavaria
Helmholtz Zentrum Munchen-German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF)
Partnership for Clean Competition (PCC), Colorado, USA
Merck Healthcare KGA, Darmstadt, Germany
State of Bavaria
Helmholtz Zentrum Munchen-German Research Center for Environmental Health - German Federal Ministry of Education and Research (BMBF)
Partnership for Clean Competition (PCC), Colorado, USA
Merck Healthcare KGA, Darmstadt, Germany