{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T12:06:09Z","timestamp":1777723569145,"version":"3.51.4"},"reference-count":50,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Carlos III Health Institute (ISCIII)","award":["PI17\/01495"],"award-info":[{"award-number":["PI17\/01495"]}]},{"name":"Carlos III Health Institute (ISCIII)","award":["PI20\/00923"],"award-info":[{"award-number":["PI20\/00923"]}]},{"name":"Carlos III Health Institute (ISCIII)","award":["RTC2019-006826-1"],"award-info":[{"award-number":["RTC2019-006826-1"]}]},{"name":"Carlos III Health Institute (ISCIII)","award":["RD09\/0076\/00101"],"award-info":[{"award-number":["RD09\/0076\/00101"]}]},{"name":"Spain\u2019s Ministry of Science and Innovation","award":["PI17\/01495"],"award-info":[{"award-number":["PI17\/01495"]}]},{"name":"Spain\u2019s Ministry of Science and Innovation","award":["PI20\/00923"],"award-info":[{"award-number":["PI20\/00923"]}]},{"name":"Spain\u2019s Ministry of Science and Innovation","award":["RTC2019-006826-1"],"award-info":[{"award-number":["RTC2019-006826-1"]}]},{"name":"Spain\u2019s Ministry of Science and Innovation","award":["RD09\/0076\/00101"],"award-info":[{"award-number":["RD09\/0076\/00101"]}]},{"name":"Spanish Society of Cardiology and Carlos III Health Institute FEDER","award":["PI17\/01495"],"award-info":[{"award-number":["PI17\/01495"]}]},{"name":"Spanish Society of Cardiology and Carlos III Health Institute FEDER","award":["PI20\/00923"],"award-info":[{"award-number":["PI20\/00923"]}]},{"name":"Spanish Society of Cardiology and Carlos III Health Institute FEDER","award":["RTC2019-006826-1"],"award-info":[{"award-number":["RTC2019-006826-1"]}]},{"name":"Spanish Society of Cardiology and Carlos III Health Institute FEDER","award":["RD09\/0076\/00101"],"award-info":[{"award-number":["RD09\/0076\/00101"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Mineral metabolism (MM), mainly fibroblast growth factor-23 (FGF-23) and klotho, has been linked to cardiovascular (CV) diseases. Cardiac rehabilitation (CR) has been demonstrated to reduce CV events, although its potential relationship with changes in MM is unknown. Methods: We performed a prospective, observational, case-control study, with acute coronary syndrome (ACS) patients who underwent CR and control patients (matched by age, gender, left ventricular ejection fraction, diabetes, and coronary artery bypass grafting), who did not. The inclusion dates were from August 2013 to November 2017 in CR group and from July 2006 to June 2014 in control group. Clinical, biochemical, and MM biomarkers were collected at discharge and six months later. Our objective was to evaluate differences in the modification pattern of MM in both groups. Results: We included 58 CR patients and 116 controls. The control group showed a higher prevalence of hypertension (50.9% vs. 34.5%), ST-elevated myocardial infarction (59.5% vs. 29.3%), and treatment with angiotensin-converting enzyme inhibitors (100% vs. 69%). P2Y12 inhibitors and beta-blockers were more frequently prescribed in the CR group (83.6% vs. 96.6% and 82.8% vs. 94.8%, respectively). After six months, klotho levels increased in CR patients whereas they were reduced in controls (+63 vs. \u221249 pg\/mL; p &lt; 0.001). FGF-23 was unchanged in the CR group and reduced in controls (+0.2 vs. \u221217.3 RU\/dL; p &lt; 0.003). After multivariate analysis, only the change in klotho levels was significantly different between groups (+124 pg\/mL favoring CR group; IC 95% [+44 to +205]; p = 0.003). Conclusions: In our study, CR after ACS increases plasma klotho levels without significant changes in other components of MM. Further studies are needed to clarify whether this effect has a causal role in the clinical benefit of CR.<\/jats:p>","DOI":"10.3390\/jcm13061664","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T05:43:08Z","timestamp":1710394988000},"page":"1664","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiac Rehabilitation Increases Plasma Klotho Levels"],"prefix":"10.3390","volume":"13","author":[{"given":"Ana Mar\u00eda","family":"Pello L\u00e1zaro","sequence":"first","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koldo","family":"Villelabeitia Jaureguizar","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Hospital Universitario Infanta Elena, 28340 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5360-7066","authenticated-orcid":false,"given":"Juan Antonio","family":"Franco Pel\u00e1ez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0603-0094","authenticated-orcid":false,"given":"Ana","family":"Venegas-Rodriguez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1lvaro","family":"Ace\u00f1a","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2644-1026","authenticated-orcid":false,"given":"Andrea","family":"Kallmeyer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ester","family":"C\u00e1novas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1268-7191","authenticated-orcid":false,"given":"Mar\u00eda Luisa","family":"Gonz\u00e1lez-Casaus","sequence":"additional","affiliation":[{"name":"Unitof Mineral Metabolism, Department of Laboratory Medicine, Hospital La Paz, 28046 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nieves","family":"Tar\u00edn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de M\u00f3stoles, 28935 Madrid, Spain"},{"name":"Faculty of Medicine, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Crist\u00f3bal","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"},{"name":"Department of Cardiology, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5807-0894","authenticated-orcid":false,"given":"Carlos","family":"Guti\u00e9rrez-Landaluce","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario de Fuenlabrada, 28942 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Huelmos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Universitario Fundaci\u00f3n Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4342-8050","authenticated-orcid":false,"given":"\u00d3scar","family":"Gonz\u00e1lez-Lorenzo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital de Getafe, 28905 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorenzo","family":"L\u00f3pez-Besc\u00f3s","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Egido","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"},{"name":"CIBERDEM (Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre), 28029 Madrid, Spain"},{"name":"Renal, Vascular and Diabetes Research Laboratory, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0558-6541","authenticated-orcid":false,"given":"Ignacio","family":"Mahillo-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Unit, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3458-0328","authenticated-orcid":false,"given":"Jairo","family":"Lumpuy-Castillo","sequence":"additional","affiliation":[{"name":"CIBERDEM (Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre), 28029 Madrid, Spain"},{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5515-6078","authenticated-orcid":false,"given":"\u00d3scar","family":"Lorenzo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"},{"name":"CIBERDEM (Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre), 28029 Madrid, Spain"},{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1373-0999","authenticated-orcid":false,"given":"Jos\u00e9","family":"Tu\u00f1\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Cardiology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Faculty of Medicine, Aut\u00f3noma University, 28029 Madrid, Spain"},{"name":"Laboratory of Vascular Pathology, IIS-Fundaci\u00f3n Jim\u00e9nez D\u00edaz, 28040 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red Enfermedades Cardiovaculares (CIBERCV), ISCIII, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"ESC Guidelines on cardiovascular disease prevention in clinical practice","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","first-page":"CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","volume":"2016","author":"Anderson","year":"2016","journal-title":"Emergencias"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1177\/2047487320905719","article-title":"Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: Update of the Cardiac Rehabilitation Outcome Study (CROS-II)","volume":"27","author":"Salzwedel","year":"2020","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e12902","DOI":"10.1111\/eci.12902","article-title":"PTH, vitamin D, and the FGF-23\u2013klotho axis and heart: Going beyond the confines of nephrology","volume":"48","author":"Delgado","year":"2018","journal-title":"Eur. J. Clin. Investig."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1038\/nrneph.2013.111","article-title":"Klotho, phosphate and FGF-23 in ageing and disturbed mineral metabolism","volume":"9","year":"2013","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1681\/ASN.2013050465","article-title":"Fibroblast Growth Factor-23 and Cardiovascular Events in CKD","volume":"25","author":"Scialla","year":"2014","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1001\/jamacardio.2016.1445","article-title":"Association of Fibroblast Growth Factor 23 with Atrial Fibrillation in Chronic Kidney Disease, from the Chronic Renal Insufficiency Cohort Study","volume":"1","author":"Mehta","year":"2016","journal-title":"JAMA Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1161\/CIRCULATIONAHA.108.844506","article-title":"Fibroblast Growth Factor 23 and Left Ventricular Hypertrophy in Chronic Kidney Disease","volume":"119","author":"Januzzi","year":"2009","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1161\/HYPERTENSIONAHA.118.11060","article-title":"FGF23 (Fibroblast Growth Factor-23) and Incident Hypertension in Young and Middle-Aged Adults","volume":"72","author":"Akhabue","year":"2018","journal-title":"Hypertension"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1038\/ki.2012.327","article-title":"Higher fibroblast growth factor-23 increases the risk of all-cause and cardiovascular mortality in the community","volume":"83","author":"Carlsson","year":"2013","journal-title":"Kidney Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jacc.2012.03.040","article-title":"Fibroblast Growth Factor-23 and Death, Heart Failure, and Cardiovascular Events in Community-Living Individuals: CHS (Cardiovascular Health Study)","volume":"60","author":"Ix","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"640","DOI":"10.7326\/0003-4819-152-10-201005180-00004","article-title":"The Associations of Fibroblast Growth Factor 23 and Uncarboxylated Matrix Gla Protein with Mortality in Coronary Artery Disease: The Heart and Soul Study","volume":"152","author":"Parker","year":"2010","journal-title":"Ann. Intern. Med."},{"key":"ref_13","first-page":"587","article-title":"Important abnormalities of bone mineral metabolism are present in patients with coronary artery disease with a mild decrease of the estimated glomerular filtration rate","volume":"34","author":"Lorenzo","year":"2015","journal-title":"J. Bone Miner. Metab."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Tu\u00f1\u00f3n, J., Crist\u00f3bal, C., Vicente, M.N.T., Ace\u00f1a, \u00c1., Gonzalez-Casaus, M.L., Huelmos, A., Alonso, J.J., Lorenzo, \u00d3., Gonz\u00e1lez-Parra, E., and Mah\u00edllo-Fern\u00e1ndez, I. (2014). Coexistence of Low Vitamin D and High Fibroblast Growth Factor-23 Plasma Levels Predicts an Adverse Outcome in Patients with Coronary Artery Disease. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0095402"},{"key":"ref_15","first-page":"701","article-title":"Decreased expression of Klotho in cardiac atria biopsy samples from patients at higher risk of atherosclerotic cardiovascular disease","volume":"13","author":"Corsetti","year":"2016","journal-title":"J. Geriatr. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.bbrc.2016.03.029","article-title":"Klotho inhibits angiotensin II-induced cardiomyocyte hypertrophy through suppression of the AT1R\/beta catenin pathway","volume":"473","author":"Yu","year":"2016","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/36285","article-title":"Mutation of the mouse klotho gene leads to a syndrome resembling ageing","volume":"390","author":"Matsumura","year":"1997","journal-title":"Nature"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"6120","DOI":"10.1074\/jbc.C500457200","article-title":"Regulation of Fibroblast Growth Factor-23 Signaling by Klotho","volume":"281","author":"Kurosu","year":"2006","journal-title":"J. Biol. Chem."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1006\/bbrc.1997.8019","article-title":"Identification of the Human Klotho Gene and Its Two Transcripts Encoding Membrane and Secreted Klotho Protein","volume":"242","author":"Matsumuraab","year":"1998","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1038\/s41581-018-0078-3","article-title":"The Klotho proteins in health and disease","volume":"15","year":"2019","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1006\/bbrc.1998.8943","article-title":"Klotho Protein Protects against Endothelial Dysfunction","volume":"248","author":"Saito","year":"1998","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1111\/j.1532-5415.2011.03558.x","article-title":"Plasma Klotho and Cardiovascular Disease in Adults","volume":"59","author":"Semba","year":"2011","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.atherosclerosis.2014.04.026","article-title":"The effect of physical activity or exercise on key biomarkers in atherosclerosis\u2014A systematic review","volume":"235","author":"Palmefors","year":"2014","journal-title":"Atherosclerosis"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.amjcard.2013.10.012","article-title":"Usefulness of a Combination of Monocyte Chemoattractant Protein-1, Galectin-3, and N-Terminal Probrain Natriuretic Peptide to Predict Cardiovascular Events in Patients with Coronary Artery Disease","volume":"113","author":"Higueras","year":"2014","journal-title":"Am. J. Cardiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1002\/ehf2.14568","article-title":"Fibroblast growth factor 23 independently predicts adverse outcomes after an acute coronary syndrome","volume":"11","author":"Kallmeyer","year":"2023","journal-title":"ESC Heart Fail."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A New Equation to Estimate Glomerular Filtration Rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0140-6736(20)31561-0","article-title":"Sex and gender: Modifiers of health, disease, and medicine","volume":"396","author":"Merz","year":"2020","journal-title":"Lancet"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.1161\/CIRCULATIONAHA.117.030798","article-title":"Acute Myocardial Infarction","volume":"136","author":"Puymirat","year":"2017","journal-title":"Circulation"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"2018 ESC\/EACTS Guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2698","DOI":"10.18632\/aging.102771","article-title":"Relationship between plasma S-Klotho and cardiometabolic risk in sedentary adults","volume":"12","author":"Castillo","year":"2020","journal-title":"Aging"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lee, J., Kim, D., Lee, H.-J., Choi, J.-Y., Min, J.-Y., and Min, K.-B. (2022). Association between serum klotho levels and cardiovascular disease risk factors in older adults. BMC Cardiovasc. Disord., 22.","DOI":"10.1186\/s12872-022-02885-2"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2147\/ciia.2006.1.3.213","article-title":"Anti-aging therapy through fitness enhancement","volume":"1","author":"Ruiz","year":"2006","journal-title":"Clin. Interv. Aging"},{"key":"ref_33","first-page":"e30245","article-title":"Serum Klotho Levels in Trained Athletes","volume":"8","author":"Mostafidi","year":"2016","journal-title":"Nephro-Urology Mon."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Tan, S.-J., Chu, M.M., Toussaint, N.D., Cai, M.M., Hewitson, T.D., and Holt, S.G. (2018). High-intensity physical exercise increases serum \u03b1-klotho levels in healthy volunteers. J. Circ. Biomark., 7.","DOI":"10.33393\/jcb.2018.2093"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"17587","DOI":"10.1038\/s41598-022-22123-1","article-title":"A systematic review and meta-analysis demonstrating Klotho as an emerging exerkine","volume":"12","author":"Raab","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1080\/15412555.2016.1272563","article-title":"Assessment of the Anti-Aging Klotho Protein in Patients with COPD Undergoing Pulmonary Rehabilitation","volume":"14","author":"Pako","year":"2017","journal-title":"COPD J. Chronic Obstr. Pulm. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz-Casta\u00f1eda, J.R., Rodelo-Haad, C., de Mier, M.V.P.-R., Martin-Malo, A., Santamaria, R., and Rodriguez, M. (2020). Klotho\/FGF23 and Wnt Signaling as Important Players in the Comorbidities Associated with Chronic Kidney Disease. Toxins, 12.","DOI":"10.3390\/toxins12030185"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1152\/japplphysiol.00416.2020","article-title":"Dynamic not isometric training blunts osteo-renal disease and improves the sclerostin\/FGF23\/Klotho axis in maintenance hemodialysis patients: A randomized clinical trial","volume":"130","author":"Neves","year":"2021","journal-title":"J. Appl. Physiol."},{"key":"ref_39","first-page":"249","article-title":"Blood Flow Restriction Training Blunts Chronic Kidney Disease Progression in Humans","volume":"53","author":"Neves","year":"2020","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Hellberg, M., Hellmark, T., H\u00f6glund, P., and Clyne, N. (2020). Twelve months of exercise training did not halt abdominal aortic calcification in patients with CKD\u2014A sub-study of RENEXC-a randomized controlled trial. BMC Nephrol., 21.","DOI":"10.1186\/s12882-020-01881-y"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.cardfail.2020.09.477","article-title":"Fibroblast Growth Factor 23 and Exercise Capacity in Heart Failure with Preserved Ejection Fraction","volume":"27","author":"Ghuman","year":"2020","journal-title":"J. Card. Fail."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1001\/jamacardio.2018.0653","article-title":"Association of Fibroblast Growth Factor 23 with Recurrent Cardiovascular Events in Patients after an Acute Coronary Syndrome","volume":"3","author":"Bergmark","year":"2018","journal-title":"JAMA Cardiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.ijcard.2021.05.028","article-title":"Discharge FGF23 level predicts one year outcome in patients admitted with acute heart failure","volume":"336","author":"Vergaro","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"989574","DOI":"10.3389\/fcvm.2022.989574","article-title":"Fibroblast growth factor-23 and the risk of cardiovascular diseases and mortality in the general population: A systematic review and dose-response meta-analysis","volume":"9","author":"Liu","year":"2022","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"83","DOI":"10.5334\/gh.1170","article-title":"The Effect of Cardiac Rehabilitation on Lipid Levels in Patients with Coronary Heart Disease. A Systematic Review and Meta-Analysis","volume":"17","author":"Wu","year":"2022","journal-title":"Glob. Heart"},{"key":"ref_46","first-page":"192","article-title":"The Role of the Characteristics of Exercise-Based Cardiac Rehabilitation Program in the Improvement of Lipid Profile Level: A Systematic Review and Meta-Analysis","volume":"16","author":"Javaherian","year":"2020","journal-title":"ARYA Atheroscler."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/00008483-200509000-00004","article-title":"Independent Effect of Cardiac Rehabilitation on Lipids in Coronary Artery Disease","volume":"25","author":"Snow","year":"2005","journal-title":"J. Cardiopulm. Rehab."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"S502","DOI":"10.1097\/00005768-200106001-00021","article-title":"Response of blood lipids to exercise training alone or combined with dietary intervention","volume":"33","author":"Leon","year":"2001","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1056\/NEJMoa020194","article-title":"Effects of the Amount and Intensity of Exercise on Plasma Lipoproteins","volume":"347","author":"Kraus","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/00008483-200509000-00006","article-title":"Cardiac Rehabilitation and Getting to Lipid Goals","volume":"25","author":"Wilson","year":"2005","journal-title":"J. Cardiopulm. 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