Klotho Reduces the Risk of Osteoporosis in Postmenopausal Women: A cross-sectional Study of the National Health and Nutrition Examination Survey (NHANES)

Abstract Background: We explored a convenient and accurate factor to predict the risk factors of osteoporosis (OP) in postmenopausal women based on the study of the database. Methods: This is a retrospective study. We searched and collected the data of 3 survey cycles in the National Health and Nutrition Examination Survey (NHANES) database, and included 885 postmenopausal women over 50 years old. All participants took dual-energy X-ray absorptiometry examination and serum Klotho test at the time of investigation. We used logistic regression to predict the risk model, and used P for trend and restricted cubic spline (RCS) to explore the nonlinear relationship between variables. Results : The influencing factors of OP included age, race, BMI and Klotho. Klotho is a protective factor (OR[log2Klotho] =0.561, P =0.023). We build a prediction model to evaluate the prediction ability. The C-index is 0.765, indicating a good prediction ability. After adjusting the full variable, P for trend has significant difference. RCS showed that when Klotho concentration reached 824.09pg/ml, the risk of OP decreased significantly. Conclusion: Through the study of NHANES database, we propose that Klotho is a protective factor for postmenopausal OP, and it can be used to assess the risk of OP.