title: Reduced Klotho is associated with the presence and severity of coronary artery disease.
abstract: OBJECTIVE
  Klotho is involved in vascular health. We aimed to analyse in a cross-sectional study the relationship between Klotho and human coronary artery disease (CAD).
  
  
  METHODS
  The study included 371 subjects who underwent coronary angiography and 70 patients who underwent elective cardiac surgery recruited between May 2008 and June 2009. The presence and severity (stenosis index) of CAD, cardiovascular risk factors, Klotho gene expression in the thoracic aorta, and serum soluble Klotho concentrations were evaluated.
  
  
  RESULTS
  The soluble Klotho concentration was lower (p<0.001) in patients with significant CAD (n=233). The maximal stenosis observed in every epicardial artery and the stenosis severity index was significantly lower in patients within the higher soluble Klotho concentrations (p<0.0001). Multiple regression analysis showed that serum Klotho concentrations were inverse and significantly associated with CAD (adjusted R(2)=0.67, p<0.001). Multivariate logistic regression analysis showed that risk factors for significant CAD included age, diabetes, smoking and inflammation, whereas high serum Klotho values were associated with a lower risk for CAD. Lower mRNA expression level of Klotho was observed in 46 patients with significant CAD, as compared with subjects without CAD (p=0.01). Logistic regression analysis showed that high Klotho gene expression was independently associated with lower risk for CAD.
  
  
  CONCLUSIONS
  Patients with significant CAD present lower soluble concentrations of Klotho, as well as reduced levels of Klotho gene expression in the vascular wall. Reduced serum Klotho concentrations and decreased vascular Klotho gene expression were associated with the presence and severity of CAD independently of established cardiovascular risk factors.
authors.affiliation: Research Division, Hospital Universitario Nuestra Señora de Candelaria, , Santa Cruz de Tenerife, Spain.
authors.forename: Juan F
authors.initials: JF
authors.lastname: Navarro-González
authors.forename: Javier
authors.initials: J
authors.lastname: Donate-Correa
authors.forename: Mercedes
authors.initials: M
authors.lastname: Muros de Fuentes
authors.forename: Horacio
authors.initials: H
authors.lastname: Pérez-Hernández
authors.forename: Rafael
authors.initials: R
authors.lastname: Martínez-Sanz
authors.forename: Carmen
authors.initials: C
authors.lastname: Mora-Fernández
mesh_terms: D000368:Aged; D000375:Aging; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000601:surgery; D003331:Coronary Vessels / Q000378:metabolism*; D005260:Female; D005786:Gene Expression Regulation; D005966:Glucuronidase / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D000090265:Klotho Proteins; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012313:RNA / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D012313:RNA; D005966:Glucuronidase; D000090265:Klotho Proteins
keywords: Coronary Artery Disease