{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:47:18Z","timestamp":1787316438224,"version":"build-2736575974"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Merck Healthcare KGA","award":["120000R319"],"award-info":[{"award-number":["120000R319"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Concentrations of soluble alpha klotho (s\u03b1KL) are higher in active acromegaly compared with healthy controls. However, reference intervals based on large population-based samples are lacking, and the impact of many biological variables is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We measured s\u03b1KL concentrations in samples from an adult population (20-89 years, 435 males, 455 females). Associations with sex, age, body mass index, waist-hip-ratio, estimated glomerular filtration rate (eGFR), IGF-I and IGFBP 3, glucose-, lipid-, calcium- and liver-metabolism, fasting, and estrogen status were analyzed. Reference intervals were calculated using LMS quantile regression with a Box-Cox transformation to normality. We also analyzed s\u03b1KL in patients with non-functioning pituitary adenoma (NFPA, n = 18) and prolactinoma (n = 65).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across all ages, s\u03b1KL concentrations (pg\/mL, median [interquartile ranges]) were slightly, but significantly higher in females compared with males (678 (537-859) vs. 651 (537-812), P = .01), suggesting an impact of estrogens. S\u03b1KL exhibited a weak negative correlation with age, and positive correlations with eGFR and IGF-I (P &amp;lt; .001 for both). Correlations to other biological factors including glucose, liver and calcium metabolism and duration of fasting were negligible (P &amp;gt; .05 for all). Compared with s\u03b1KL, IGF-I more often was correlated significantly to other biological variables. S\u03b1KL was not different in patients with NFPA, but slightly higher in patients with prolactinoma (P &amp;lt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest s\u03b1KL is a stable GH-sensitive biomarker that may be less impacted by biological variables compared with IGF-I and IGFBP 3. Our reference intervals will facilitate the potential use of s\u03b1KL in GH-related diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf093","type":"journal-article","created":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T07:26:45Z","timestamp":1746689205000},"page":"631-640","source":"Crossref","is-referenced-by-count":8,"title":["Soluble alpha klotho\u2014impact of biological variables and reference intervals for adults"],"prefix":"10.1093","volume":"192","author":[{"given":"J\u00fania Ribeiro de Oliveira Longo","family":"Schweizer","sequence":"first","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8667-0296","authenticated-orcid":false,"given":"Katharina","family":"Schilbach","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]},{"name":"Deggendorf Institute of Technology , 94469 Deggendorf ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Haenelt","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anica","family":"Gagliardo","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Peters","sequence":"additional","affiliation":[{"name":"Institute of Epidemiology, Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health , 85764 Neuherberg ,","place":["Germany"]},{"name":"Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty 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LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jochen","family":"Schopohl","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9817-9875","authenticated-orcid":false,"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, LMU University Hospital , LMU Munich, 80336 Munich ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lauseker","sequence":"additional","affiliation":[{"name":"Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Faculty of Medicine, LMU Munich, Pettenkofer School of Public Health , 81377 Munich 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