Klotho是一种涉及多种必要的生物进程以实现健康衰老并提供保护免受心血管疾病、炎症和各种癌症等逆境事件影响的多效激素。新兴证据表明，Klotho也是调节激素平衡的生化途径的重要成分，可能包括调节睾酮产生和男性性健康的途径，尽管数据有限且结果不一致。本研究采用NHANES 2015-2016调查周期中的767名男性参与者，旨在量化血清Klotho水平与血清睾酮水平之间的关联，以及男性性健康的临床指标（例如，睾酮：雌二醇比率、可用睾酮和游离睾酮）。我们构建了多变量线性和Logistic回归模型，以控制潜在混杂因素，并量化血清Klotho与睾酮之间的关系，以及血清Klotho与低睾酮的概率之间的关系（血清睾酮<300 ng/dL）。 观察到血清Klotho与睾酮呈正相关（β = 0.18，p = 0.04）。血清Klotho水平也被分为四分位数，并观察到睾酮水平随Klotho四分位数的增加而显着增加，以第一分位数作为参考组（β = 90.51，p = 0.001，β = 106.93，p = 0.002，β = 95.33，p = 0.03，分别代表第2、3、4个分位数）。按Klotho四分位数分组的平均睾酮值分别为306.9 ng/dL、390 ng/dL、409.3 ng/dL和436.6 ng/dL。我们对性健康的重要代理变量进行了模拟，包括可用睾酮和游离睾酮、睾酮：雌二醇比率和C-反应蛋白。与第一分位数相比，Klotho位于第二分位数的男性异常睾酮：雌二醇比率的概率明显降低（OR = 0.18，95% CI =（0.03，0.98））。 我们观察到连续血清Klotho与低睾酮的概率之间的零关联（OR = 1.0，95% CI =（1.0，1.0）），并且按四分位数分层，我们观察到Klotho第二分位数的个体低睾酮的概率明显降低，与第一分位数相比（OR = 0.21，95% CI =（0.05，0.91））。此外，C-反应蛋白与男性睾酮呈负相关（β = -4.65，p = 0.001），与Klotho四分位数也呈负相关（β = -2.28，p = 0.04，β = -2.22，p = 0.04，β = -2.28，p = 0.03，分别代表第2、3、4个分位数）。我们的研究结果支持了以往关于Klotho在男性睾酮水平和性功能中的作用的研究。未来研究有必要验证这些发现，确定其临床意义，并阐明这些关联的潜在机制。© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

Klotho is a pleotropic hormone involved in a multitude of biological processes necessary for healthy aging, and affords protection from adverse events such as cardiovascular disease, inflammation, and various cancers. Emerging evidence suggests that klotho is also an important component of biochemical pathways that regulate hormone balance, which may include those pathways governing testosterone production and men's sexual health, though data are limited and results are mixed.Using a cohort of 767 men from the NHANES 2015-2016 survey cycle, we set out to quantify the association between serum klotho levels and serum testosterone levels, as well as clinical markers of men's sexual health (e.g., testosterone:estrogen ratio, bioavailable testosterone, and free testosterone).Multivariable linear and logistic regression models while controlling for potential confounders were constructed to quantify the relationship between serum klotho and testosterone, as well as between serum klotho and odds of low testosterone (serum testosterone < 300 ng/dL).A positive association was observed between serum klotho and testosterone (β = 0.18, p = 0.04). Serum klotho levels were also stratified into quartiles, and we observed statistically significant increases in testosterone for increasing quartile level of klotho using the first quartile as the reference group (β = 90.51, p = 0.001, β = 106.93, p = 0.002, β = 95.33, p = 0.03 for quartiles 2, 3, and 4, respectively). The average testosterone values by quartiles of klotho were 306.9 ng/dL, 390 ng/dL, 409.3 ng/dL, and 436.6 ng/dL, respectively. We modeled important proxies for sexual health including bioavailable and free testosterone, the testosterone:estradiol ratio, and C-reactive protein. Men in the second quartile of klotho had a significantly lower odds of an abnormal testosterone:estradiol ratio compared to the first quartile [OR = 0.18, 95% CI = (0.03, 0.98)].We observed null associations between continuous serum klotho and odds of low testosterone [OR = 1.0, 95% CI = (1.0, 1.0)], and when stratified by quartile, we observed a significant decrease in the odds of low testosterone for individuals in the second quartile of klotho compared to the first quartile [OR = 0.21, 95% CI = (0.05, 0.91)]. In addition, C-reactive protein was inversely associated with testosterone in men (β = - 4.65, p = 0.001), and inversely associated with quartiles of klotho (β = - 2.28, p = 0.04, β = - 2.22, p = 0.04, β = - 2.28, p = 0.03, for quartiles 2, 3, and 4, respectively).Our findings support previous studies suggesting a role for klotho in testosterone levels and sexual function among men. Future studies are warranted to corroborate these findings, determine clinical significance, and elucidate potential mechanisms underlying these associations.© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.