Circulating α-Klotho and Multidimensional Aging and Frailty Outcomes: A Systematic Review and Meta-Analysis from the European Renal Association CKD-MBD Working Group
= 100%). Lower circulating α-Klotho levels were observed in individuals with osteoporosis compared with those with normal BMD (95% CI: - 114.98, - 25.49; p = 0.002) and in individuals with osteopenia compared with those with normal BMD (95% CI: - 123.22, - 0.74; p = 0.05), and were associated with fractures. Based on qualitative synthesis, circulating α-Klotho levels were positively associated with multiple physical function outcomes, including grip strength, short physical performance battery scores, and sit-to-stand performance, with mixed findings for gait speed and the 6-min walk test. Circulating α-Klotho appears to be a promising biomarker for frailty, physical function, and bone health in aging; however, evidence for cognitive outcomes remains limited and inconsistent. Substantial heterogeneity and the observational nature of most studies highlight the need for more standardized and longitudinal research.
Authors
- Laşin Özbek (ORCID: https://orcid.org/0000-0002-2828-555X)
- Juan Miguel Díaz‐Tocados (ORCID: https://orcid.org/0000-0001-5192-5212)
- Carlo Alfieri (ORCID: https://orcid.org/0000-0003-3860-5219)
- Mathias Haarhaus (ORCID: https://orcid.org/0000-0001-8274-6356)
- Pietro Manuel Ferraro (ORCID: https://orcid.org/0000-0002-1379-022X)
- Antonio Bellasi (ORCID: https://orcid.org/0000-0001-7830-1645)
- Mustafa Güldan (ORCID: https://orcid.org/0000-0002-0480-5370)
- Arif Emir Narin
- Derya Göksu Fidan (ORCID: https://orcid.org/0009-0000-6686-9604)
- Mehmet Kanbay (ORCID: https://orcid.org/0000-0002-1297-0675)
- Ditte Hansen
- Martin H de Borst
Institutions
- University of Copenhagen (DK)
- University Medical Center Groningen (NL)
- Karolinska University Hospital (SE)
- Koç University (TR)
- University of Groningen (NL)
- University of Milan (IT)
- Herlev Hospital (DK)
- Copenhagen University Hospital (DK)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Karolinska Institutet (SE)
- Ospedale regionale di Lugano (CH)
- Azienda Ospedaliera Universitaria Integrata Verona (IT)
- Ente Ospedaliero Cantonale (CH)
- Unidad de Investigación en cuidados y servicios de salud (Investén-isciii) (ES)
- Instituto de Investigación Biomédica de Lleida (ES)
- Università della Svizzera italiana (CH)
Publication Details
- Journal
- Calcified Tissue International
- Published
- 2026-04-30
- DOI
- https://doi.org/10.1007/s00223-026-01537-3
- Primary Topic
- Parathyroid Disorders and Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Koç Üniversitesi