Abstract
This study assessed the association between serum α-Klotho levels and hyperlipidemia. The aim was to ascertain the potential of serum α-Klotho levels as a predictive biomarker for hyperlipidemia. The research employed data from the National Health and Nutrition Examination Survey (NHANES) between 2013 and 2016. Weighted logistic regression analyses were employed to investigate the association between serum α-Klotho levels and hyperlipidemia. Restricted cubic spline (RCS) analyses were executed for males and females to scrutinize the non-linear correlation between α-Klotho levels and hyperlipidemia. Subsequently, piecewise logistic regression analysis was carried out based on the RCS findings. In females, the levels of α-Klotho were notably lower in those with hyperlipidemia in comparison to those without this condition (P < 0.05), No significant variation was demonstrated in α-Klotho levels between males with and without hyperlipidemia (P > 0.05). The participants were stratified by sex and subjected to analysis by logistic regression model. When α-Klotho was log2-transformed, it was significantly negatively associated with the risk of hyperlipidemia in females, even after adjusting for all of the covariates (OR 0.45, 95% CI 0.24-0.82), which was not observed in males (OR 1.14, 95% CI 0.63-2.06). The same results were observed in the third tertile of α-Klotho. Moreover, RCS analysis suggested a nonlinear correlation between serum α-Klotho levels and hyperlipidemia in females (P < 0.01). The inflection point of α-Klotho was found to be 1106.87 pg/mL. The piecewise logistic regression model revealed that when α-Klotho levels exceeded 1106.87 pg/mL, the link between α-Klotho and hyperlipidemia was no longer significant (P > 0.05). This investigation highlights the sex-based variation in the link between serum α-Klotho levels and hyperlipidemia. In females, α-Klotho exhibited negative association with hyperlipidemia, displaying a saturation effect. Serum α-Klotho emerges as a promising biological marker for the risk of hyperlipidemia among females.