{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T01:12:31Z","timestamp":1778634751430,"version":"3.51.4"},"reference-count":64,"publisher":"Baishideng Publishing Group Inc.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Clin Pediatr"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n                  <jats:p>The identification of bioindicators for the detection and monitoring of autism spectrum disorder (ASD) still remains a major challenge in clinical medicine. The protein klotho has been linked to various neurological disorders.<\/jats:p>\n                  <jats:p>AIM<\/jats:p>\n                  <jats:p>To investigate the evaluation of soluble alpha-klotho (S-KL\u03b1) as a new indicator for the diagnosis and monitoring of patients with ASD. This study was conducted in the absence of any prior studies or research on the link between klotho and ASD, nor on how it affects the characteristics of those impacted. To address this gap, we considered this study.<\/jats:p>\n                  <jats:p>METHODS<\/jats:p>\n                  <jats:p>The case-control study involved 256 individuals of both sexes, aged between 2 years and 15 years, divided into two groups: 156 children with ASD from autism centers in Dohuk and Zakho cities, Kurdistan Region\/Iraq, and 100 healthy individuals serving as the control group. Serum S-KL\u03b1 level was measured using enzyme-linked immunosorbent assay. Additionally, levels of hemoglobin, iron, glucose, uric acid, creatinine, and vitamin D3 were estimated, with all measurements conducted in duplicate. Afterwards, statistical analyses were performed. An additional component was a questionnaire containing information about the participants.<\/jats:p>\n                  <jats:p>RESULTS<\/jats:p>\n                  <jats:p>The results showed a significant decrease in S-KL\u03b1 levels in the sera of patients with ASD (97.5 \u00b1 19.6) compared to the control group (133.7 \u00b1 32.4). Additionally, the area under the curve (0.91) from the receiver operating characteristic analysis confirms the potential of using S-KL\u03b1 as a marker for ASD. Furthermore, a notable decline in S-KL\u03b1 was observed with increasing age, and higher levels of S-KL\u03b1 were found in girls compared to boys, in both the control and patient groups (P  &lt; 0.001). The S-KL\u03b1 levels in patients with ASD were not influenced by family history or birth weight. However, a significant reduction was seen in patients who experienced a difficult birth (dystocia), as well as in preterm births (&lt; 37 weeks) and post-term births (&gt; 42 weeks). It was observed that there was a significantly negative correlation between S-KL\u03b1 and glucose level. By contrast, positive correlations were found with hemoglobin, iron, and vitamin D3 (P  &lt; 0.01); however, no relationship was detected with creatinine and uric acid levels in patients with ASD.<\/jats:p>\n                  <jats:p>CONCLUSION<\/jats:p>\n                  <jats:p>This is the first case-control study to confirm the strong potential of serum S-KL\u03b1 as a predictive biomarker in autism risk profiling. The proposals outlined by the study suggest new directions and strategies for future research, linking klotho as a potential diagnostic marker for ASD and its complications, as well as its possible role as a therapeutic target.<\/jats:p>","DOI":"10.5409\/wjcp.v15.i2.112164","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:27:12Z","timestamp":1778632032000},"source":"Crossref","is-referenced-by-count":0,"title":["Role of soluble alpha-klotho as a novel biomarker for characterizing children with autism spectrum disorder in Kurdistan, Iraq"],"prefix":"10.5409","volume":"15","author":[{"given":"Thikra A","family":"Allwsh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dezheen 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