Serum Klotho as a feasible diagnostic biomarker for metabolic syndrome in Iraqi adults aged over 50 years
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Abstract
Background: Metabolic Syndrome (MetS) is a cluster of cardiometabolic risk factors primarily driven by insulin resistance, with a high prevalence in older adult populations.
Objectives: This study aimed to evaluate the diagnostic accuracy of serum Klotho Beta (KLB) and insulin as novel biomarkers for MetS in Iraqi adults over 50 years old.
Materials and methods: This case-control study included 60 MetS patients and 30 healthy controls, recruited from Iraqi hospitals. MetS was diagnosed using harmonized IDF/AHA/NCEP ATP III criteria. Serum Klotho Beta and insulin levels were measured by ELISA.
Results: Serum Klotho Beta levels were significantly lower in the MetS group (25.54±4.41 nmol/L) compared to controls (59.00±11.05 nmol/L, p<0.001). Klotho Beta was inversely correlated with HOMA-IR (r=-0.59, p<0.001), BMI, HbA1c, and triglycerides, and positively with HDL-C. ROC analysis showed an AUC of 0.997 for Klotho Beta (sensitivity 95%, specificity 100% at ≤35.248 nmol/L) and an AUC of 0.998 for insulin. Logistic regression confirmed Klotho Beta as a strong independent predictor of MetS (OR=1.85 per 1 nmol/L decrease).
Conclusion: Serum Klotho Beta and insulin are highly sensitive and specific biomarkers for MetS in older adults. Klotho Beta deficiency, coupled with hyperinsulinemia, reflects underlying insulin resistance and metabolic dysregulation, highlighting its potential for risk stratification and early diagnosis in high-risk populations.
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