血清Klotho蛋白水平与老年衰弱的相关性研究

The correlation between serum Klotho levels and frailty in elderly people

目的探讨血清Klotho蛋白水平与老年人衰弱的相关性。方法横断面调查研究,选择苏州社区年度体检65岁及以上老年人150例,采用Fried表型进行衰弱评估,包括衰弱组50例(33.3%)、衰弱前期组47例(31.3%)、无衰弱组53例(35.3%)。收集老年人的一般情况及血检验结果,完成简易体能测量表(SPPB)、人体成分分析的检测。应用酶联免疫吸附法(ELISA)检测血清中的Klotho蛋白水平,采用Logistic回归分析衰弱的影响因素。结果衰弱组Klotho蛋白水平低于无衰弱组(P=0.001),而衰弱组与衰弱前期组、衰弱前期组与无衰弱组比较差异均无统计学意义(均P>0.05)。Klotho蛋白水平按3个四分位数值(2.28、3.52、5.09 mg/L)分为4个四分位数区间Q1、Q2、Q3、Q4,衰弱在该四分位数区间的患病率分别为51.4%(19/37)、39.5%(15/38)、24.3%(9/37)、18.4%(7/38),随着Klotho蛋白水平的升高,衰弱患病率降低(χ^(2)=11.204、P=0.011)。Spearman相关性分析结果显示,Klotho蛋白与衰弱呈负相关(r=-0.310、P<0.001)。多因素Logistic回归分析结果显示,年龄(OR=1.109、95%CI:1.011~1.217、P=0.028)、肌少症(OR=6.511、95%CI:1.279~33.147、P=0.024)是衰弱的危险因素,而步行锻炼(OR=0.104、95%CI:0.033~0.326、P<0.001)、SPPB评分高(OR=0.780、95%CI:0.627~0.970、P=0.026)、Klotho蛋白水平(OR=0.752、95%CI:0.581~0.974、P=0.031)是衰弱的保护因素。结论血清Klotho蛋白水平可能对衰弱的评估有指导意义,血清Klotho蛋白水平与衰弱呈负相关,提示血清低水平Klotho蛋白老年人更易发生衰弱。

Objective To examine the correlation between serum Klotho levels and frailty in elderly people.Methods In this cross-sectional study,150 community-dwelling elderly people aged 65 years and over were enrolled.Subjects were divided into a frail(n=50,33.3%),a pre-frail(n=47,31.3%)and a non-frail(n=53,35.3%)group based on the Fried phenotype.General participant data,routine laboratory test results,short physical performance battery(SPPB)results and human body composition data were collected.Serum Klotho protein levels were measured by an enzyme-linked immunosorbent assay.The relationship between serum Klotho protein levels and frailty was analyzed by using Spearmen's correlation analysis and Logistic regression analysis.Results Klotho protein levels were lower in the frail group than in the non-frail group(P=0.001),whereas differences between the frail group and the pre-frail group and between the pre-frail group and the non-frail group were not statistically significant(all P>0.05).When Klotho protein levels were classified into four quartiles,i.e.,Q1,Q2,Q3,and Q4,using three cut-off vales(2.28,3.52,and 5.09 mg/L),the prevalences of frailty were 51.4%(19/37),39.5%(15/38),24.3%(9/37)and 18.4%(7/38),respectively.The prevalence of frailty decreased with increasing Klotho protein levels(χ^(2)=11.204,P=0.011).Spearman correlation analysis showed that the Klotho protein level was negatively correlated with frailty(r=-0.310,P<0.001).Multivariate Logistic regression analysis results showed that age(OR=1.109,95%CI:1.011-1.217,P=0.028)and sarcopenia(OR=6.511,95%CI:1.279-33.147,P=0.024)were risk factors for frailty,while walking(OR=0.104,95%CI:0.033-0.326,P<0.001),a high SPPB score(OR=0.780,95%CI:0.627-0.970,P=0.026),and a high Klotho protein level(OR=0.752,95%CI:0.581-0.974,P=0.031)were protective factors against frailty.Conclusions The serum Klotho protein level may be used as a parameter for the assessment of frailty.It is negatively correlated with frailty,suggesting that elderly people with low serum Klotho protein levels are at high risk of developing frailty.