Journal Article

Plasma Klotho concentration is associated with the presence, burden and progression of cerebral small vessel disease in patients with acute ischaemic stroke

Ryu, Dong-Ryeol, Woo, Ho Geol, Song, Tae-Jin, Chang, Yoonkyung

2019

Overview

Klotho is a soluble or membrane-bound anti-aging protein, whose protective actions are important for a prudential function of many organs. Because Klotho and cerebral small vessel disease (SVD) are associated with ageing process and endothelial dysfunction, it is possible that Klotho has an association with cerebral SVD. We aimed to investigate the association of plasma Klotho concentration with the presence, burden and progression of cerebral SVD. We prospectively enrolled 262 patients with first-ever acute cerebral infarction, performed brain MRI and collected their blood samples within 24 hours of admission. An enzyme-linked immunosorbent assay was used for evaluating plasma Klotho concentration. We estimated the total SVD score of each patient after determining the presence and burden of high-grade white matter hyperintensities (HWMHs), cerebral microbleeds (CMBs), high-grade perivascular spaces (HPVSs) and asymptomatic lacunar infarctions (ALIs). Univariate and multivariate analyses were conducted to investigate association of Klotho with cerebral SVD and the total SVD score. Of the 262 patients, 152 (58.0%) were men. The mean age of these patients was 64.7 years. The mean ± standard deviation of plasma Klotho concentration was 329.8 ± 194.1 pg/mL. In multivariate analysis, plasma Klotho concentration was negatively associated with the presence of HWMHs [Odds ratio (OR): 0.13, p = 0.047], HPVSs (OR: 0.22, p = 0.024) and ALIs (OR: 0.53, p = 0.021) but not associated with the presence of CMBs (OR: 0.39, p = 0.404). Plasma Klotho concentration was also negatively related to the total SVD score (unstandardized coefficients beta: -0.895, standard error = 0.317, p = 0.005, R2 = 0.239). Furthermore, plasma Klotho concentration was negatively related to the presence (OR: 0.75, 95% CI: 0.59-0.96, p = 0.025) and severity of cerebral SVD progression (OR: 0.72, 95% CI: 0.56-0.92, p = 0.009). In conclusion, plasma Klotho concentration was negatively associated with the presence, burden and progression of cerebral SVD.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Aging / Atherosclerosis / Autoimmune diseases / Biology and Life Sciences / Biomarkers - blood / Blood / Blood vessels / Brain / Brain - diagnostic imaging / Brain Ischemia - blood / Brain Ischemia - complications / Brain Ischemia - diagnostic imaging / Cardiac arrhythmia / Cardiovascular disease / Cerebral infarction / Cerebral Small Vessel Diseases - blood / Cerebral Small Vessel Diseases - complications / Cerebral Small Vessel Diseases - diagnostic imaging / Cost of Illness / Development and progression / Disease Progression / EDTA / Endothelium / Enzyme-linked immunosorbent assay / Enzymes / Female / Genetic aspects / Glucuronidase - blood / Health aspects / Homeostasis / Hospitals / Humans / Infarction / Ischemia / Kidney diseases / Klotho protein / Magnetic resonance imaging / Male / Medical imaging / Medicine / Medicine and Health Sciences / Membrane proteins / Middle Aged / Multivariate analysis / Neurology / Organs / Oxidative stress / Patients / Physical sciences / Prospective Studies / Protein binding / Proteins / Research and Analysis Methods / Standard error / Stroke / Stroke - blood / Stroke - complications / Stroke - diagnostic imaging / Stroke patients / Studies / Substantia alba / Vascular diseases