Publication

Excessively high soluble Klotho in patients with acromegaly

Journal Paper/Review - Apr 23, 2012

Units
PubMed
Doi

Citation
Sze L, Bernays R, Zwimpfer C, Wiesli P, Brändle M, Schmid C. Excessively high soluble Klotho in patients with acromegaly. J Intern Med 2012; 272:93-7.
Type
Journal Paper/Review (English)
Journal
J Intern Med 2012; 272
Publication Date
Apr 23, 2012
Issn Electronic
1365-2796
Pages
93-7
Brief description/objective

OBJECTIVES
Klotho-deficient mice develop a syndrome resembling accelerated ageing, and genetic variants of Klotho have been associated with human ageing. In humans, serum levels of soluble Klotho decrease with age and with chronic renal failure. The aim of our study was to examine the relationship between excess growth hormone (GH) and serum levels of Klotho in patients with acromegaly, a disease usually caused by a pituitary adenoma, which is associated with high phosphate levels and reduced life expectancy.

PATIENTS AND DESIGN
We determined the levels of soluble Klotho, GH and insulin-like growth factor 1 (IGF-1) in serum samples from 24 consecutive patients with acromegaly (nine women/15 men, age 28-76 years) before and after transsphenoidal surgery.

RESULTS
Soluble Klotho levels were excessively high at baseline (mean ± SEM, 4.2 ± 0.7 ng mL(-1) ) and correlated with GH (r = 0.64), IGF-1 (r = 0.57) and tumour size (r = 0.5). In multiple regression analysis, soluble Klotho was associated with GH after correction for age, gender and levels of creatinine and phosphate (P = 0.029). After surgery, GH and IGF-1 levels decreased in all patients (from 26.3 ± 5.2 to 2.6 ± 0.6 μg L(-1) , P <0.0001, and from 588 ± 35 to 193 ± 12 μg L(-1) , P < 0.001, 0.0001, respectively). Creatinine increased from 71 ± 3 to 80 ± 3 μmol L(-1) (P < 0.001), and phosphate decreased from 1.37 ± 0.04 to 1.06 ± 0.02 mmol L(-1) (P < 0.001). The markedly increased preoperative levels of soluble Klotho returned towards normal after surgery (0.7 ± 0.1 ng mL(-1) , P < 0.0001).

CONCLUSIONS
This is the first study to show dramatically increased soluble Klotho levels in an acquired disease in humans. Reversal following tumour removal suggests a causal relation between the GH-producing adenoma and high serum Klotho concentration in acromegaly.