ArticleBMC geriatrics2023
L-shaped association of serum α-Klotho and frailty among the middle-aged and older adults: results from NHANES 2007-2016.
Article in BMC geriatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Circulating α-Klotho and Multidimensional Aging and Frailty Outcomes: A Systematic Review and Meta-Analysis from the European Renal Association CKD-MBD Working Group.Calcified tissue international · 2026Pooled it
- Interpretable machine learning framework for frailty risk prediction using NHANES 2007-2018: A cross-sectional study.Medicine · 2026Article
- Association between serum Klotho and thrombocytopenia in middle-aged and older adults: A cross-sectional study based on NHANES.Medicine · 2026Article
- Associations of Frailty Index and Composite Dietary Antioxidant Index With Major Ocular Diseases and Analysis of Component Contributions: A Cross-Sectional Study.Translational vision science & technology · 2026Article
- Exploring the association between asthma and frailty: a cross-sectional and a bidirectional Mendelian randomization study.Archives of medical science : AMS · 2026Article
- NHANES-Derived Machine Learning Model for Early Identification of Frailty Risk in CKM: Optimizing Resource Allocation Through Predictive Analytics.Cardiovascular therapeutics · 2026Article
- Association of DNA methylation-predicted GDF15 and frailty in older adults based on NHANES 1999-2002.Medicine · 2025Article
- Interactive effect of sleep duration and trouble sleeping on frailty in chronic kidney disease: findings from NHANES, 2005-2018.Renal failure · 2025Article
- The association between frailty and recurrent pregnancy loss in reproductive-aged women: a cross-sectional study.Scientific reports · 2025Article
- Association between frailty with kidney stones disease among adults aged 20 years and older population: a cross-sectional study of NHANES 2007-2020.European journal of medical research · 2025Article
- Analysis of the relationship between abdominal aortic calcification and frailty in the middle-aged and older US population.Preventive medicine reports · 2025Article
- Relationship between novel inflammatory markers derived from high-sensitivity C-reactive protein and heart failure: a cross-sectional study.BMC cardiovascular disorders · 2025Article
- Association of frailty index with all-cause and cardiovascular mortality with different diabetic status: NHANES 1999-2018.Acta diabetologica · 2025Article
- Relationship between serum total bilirubin and frailty in middle-aged and elderly individuals.Frontiers in medicine · 2025Article
- Cumulative behavioral and metabolic determinants of health are associated with higher inflammation-related indices: insights from a cross-sectional study (NHANES 2005-2018).Frontiers in public health · 2025Article
- Association of dietary index for gut microbiota with frailty in middle-aged and older Americans: a cross-sectional study and mediation analysis.Frontiers in nutrition · 2025Article
- The association between a dietary index for the gut microbiota and frailty in older adults: emphasising the mediating role of inflammatory indicators.Frontiers in nutrition · 2025Article
- Non-linear associations and threshold effects of oxidative balance score and composite dietary antioxidant index on frailty risk in patients with cardiovascular-kidney-metabolic syndrome.Frontiers in nutrition · 2025Article
- Association of platelet-to-HDL cholesterol ratio with frailty and all-cause mortality.Lipids in health and disease · 2024Article
- The relationship between Fruit and vegetable intake and frailty: Data from NHANES 2007-2018.Heliyon · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFrailty is common and not limited to older age group. Serum α-Klotho works as a biomarker of anti-aging effect. However, there is limited research about the relationship between them in middle-aged and older people and controversy still exists.
methodsBased on data from National Health and Nutrition Examination Survey (NHANES) 2007-2016, we constructed weighted logistic regression models and conducted sensitivity tests to investigate the correlation between frailty and α-Klotho among people aged 40 to 79. And then their relationship was visualized by Restricted Cubic Spline (RCS). Finally, the stratified analyses and interaction tests of covariables was presented in the forest plot.
resultsA total of 7052 individuals were involved in this study, with mean age of 62.76 ± 0.18 years and females accounting for 51.05%. 2554 of them were in "frailty". After adjustment for relevant covariables, weighted logistic regression models showed that the odds ratio and 95% confidence interval [ORs (95%CI)] of correlation between frailty and Natural Logarithm(ln)-transformed α- Klotho[ln(α-Klotho)] was 0.63 (0.50, 0.79); we then performed a sensitivity analysis and found that the results remained stable. In model 3, individuals in quartiles 2, 3, and 4 showed statistical differences compared with the lowest ln(α-Klotho) quartiles, ORs (95% CI) were 0.74 (0.59, 0.93), 0.72 (0.57, 0.91), 0.71 (0.57, 0.87), respectively. Subsequently, non-linear associations were exhibited by RCS (p<0.001). The turning point for α-Klotho and ln(α-Klotho) were 785.7(pg/ml) and 6.67, respectively. Finally, analysis of the relationship between different levels of ln(α-Klotho) and frailty in different populations revealed differences between groups. The results of the interaction test showed that no other covariables had significant interaction with serum α-Klotho in our study.
conclusionThe L-shaped and negative correlation was found between α-Klotho and frailty among people aged 40 to 79 in the NHANES from 2007 to 2016.
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