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Letter to the Editor| Volume 19, ISSUE 12, P1139-1140, December 2018

Plasma Klotho and Mortality Risk Among Nursing Home Residents: Results From the SENIOR Cohort

Published:October 15, 2018DOI:https://doi.org/10.1016/j.jamda.2018.08.010
      Several authors suggest that circulating klotho, a single-pass transmembrane protein, could be associated with longevity.
      • Brandenburg V.M.
      • Kleber M.E.
      • Vervloet M.G.
      • et al.
      Soluble klotho and mortality: the Ludwigshafen Risk and Cardiovascular Health Study.
      • Semba R.D.
      • Cappola A.R.
      • Sun K.
      • et al.
      Relationship of low plasma klotho with poor grip strength in older community-dwelling adults: The InCHIANTI study.
      • Otani-Takei N.
      • Masuda T.
      • Akimoto T.
      • et al.
      Association between serum soluble klotho levels and mortality in chronic hemodialysis patients.
      • Marcais C.
      • Maucort-Boulch D.
      • Drai J.
      • et al.
      Circulating klotho associates with cardiovascular morbidity and mortality during hemodialysis.
      This study aimed to test the relationship between the level of plasma Klotho and mortality among a specific population of nursing home residents. To address this objective, we measured plasma klotho levels in a longitudinal cohort of 662 nursing home residents, the SENIOR cohort.
      • Buckinx F.
      • Reginster J.Y.
      • Petermans J.
      • et al.
      Relationship between frailty, physical performance and quality of life among nursing home residents: the SENIOR cohort.
      A sample of 443 subjects from the SENIOR cohort with archived blood samples available at the point of enrollment was included in the current study. This is focused on biomarkers (ie, α-Klotho) at baseline and mortality risk during 2 years of follow-up. The serum levels of α-Klotho were determined according to a solid-phase sandwich enzyme-linked immunosorbent assay kit (Immuno-Biological Laboratories, Takasaki, Japan).
      • Yamazaki Y.
      • Imura A.
      • Urakawa I.
      • et al.
      Establishment of sandwich ELISA for soluble alpha-klotho measurement: Age-dependent change of soluble alpha-klotho levels in healthy subjects.
      The primary outcome was all-cause mortality. The occurrence of death was monitored and recorded over a 24-month follow-up period. Deaths were collected from the medical records, computerized or otherwise, available in the institutions. Other sociodemographic and clinical data were also collected; age, gender, comorbid condition, and drugs consumed were obtained from the subjects' medical record. Anthropometric measurements, such as weight and height, were performed by a clinical research assistant and the body mass index (BMI) was calculated. Smoking status was self-reported. Frailty was measured by the Fried definition.
      • Fried L.P.
      • Tangen C.M.
      • Walston J.
      • et al.
      Frailty in older adults: Evidence for a phenotype.
      Serum cystatin C was measured by a particle-enhanced nephelometric immunoassay on the BNII nephelometer (Siemens Healthcare Diagnostics, Marburg, Germany) to estimate glomerular filtration rate with the Full Age Spectrum (FAS) equation (FAScys).
      • Pottel H.
      • Delanaye P.
      • Schaeffner E.
      • et al.
      Estimating glomerular filtration rate for the full age spectrum from serum creatinine and cystatin C.
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      References

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        Soluble klotho and mortality: the Ludwigshafen Risk and Cardiovascular Health Study.
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        • Cappola A.R.
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        Relationship of low plasma klotho with poor grip strength in older community-dwelling adults: The InCHIANTI study.
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        Association between serum soluble klotho levels and mortality in chronic hemodialysis patients.
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        Relationship between frailty, physical performance and quality of life among nursing home residents: the SENIOR cohort.
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