Serum klotho is inversely associated with metabolic syndrome in chronic kidney disease: Results from the KNOW-CKD study

Hyo Jin Kim, Joongyub Lee, Dong Wan Chae, Kyu Beck Lee, Su Ah Sung, Tae Hyun Yoo, Seung Hyeok Han, Curie Ahn, Kook Hwan Oh

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)


Background: Metabolic syndrome (MS) is prevalent in chronic kidney disease (CKD). Klotho, a protein linked to aging, is closely associated with CKD. Each component of MS and klotho has an association. However, little is known about the association between klotho and MS per se. We investigated the association between serum klotho levels and MS using baseline cross-sectional data obtained from a large Korean CKD cohort. Methods: Of the 2238 subjects recruited in the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD) between 2011 and 2016, 484 patients with missing data on serum klotho and extreme klotho values (values lower than the detectable range or > 6000 pg/mL) or with autosomal dominant polycystic kidney disease patients were excluded. The data of the remaining 1754 subjects were included in the present study. MS was defined using the revised National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III criteria. Serum klotho levels were measured using an enzyme-linked immunosorbent assay. Results: Mean patient age was 54.9 ± 12.1 years and 1110 (63.3%) were male. The prevalence of MS among all study subjects was 63.7% (n = 1118). The median serum klotho level was 527 pg/mL (interquartile range [IQR]: 418-656 pg/mL). Serum klotho level was significantly lower in MS patients than patients without MS (Median [IQR]; 521 pg/mL [413, 651] vs. 541 pg/mL [427, 676], respectively; P = 0.012). After adjusting for age, sex, estimated glomerular filtration rate, and overt proteinuria, serum klotho was independently associated with MS (adjusted odds ratio [OR], 0.44; 95% confidence interval, 0.23-0.82; P = 0.010). Furthermore, the adjusted OR for MS was found to be significantly increased at serum klotho levels of < 518 pg/mL (receiver operating characteristic curve cut-off value). Conclusions: Serum klotho was inversely associated with the presence of MS in patients with CKD. Trial registration: This trial was registered on on 26 June 2012 (;NCT01630486).

Original languageEnglish
Article number119
JournalBMC Nephrology
Issue number1
Publication statusPublished - 2019 Apr 3

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).

All Science Journal Classification (ASJC) codes

  • Nephrology


Dive into the research topics of 'Serum klotho is inversely associated with metabolic syndrome in chronic kidney disease: Results from the KNOW-CKD study'. Together they form a unique fingerprint.

Cite this