Introduction: Klotho has emerged as a potential protective factor for cardiovascular diseases recently. Nevertheless, the levels of serum Klotho in acute coronary syndrome (ACS) have not been reported. Hence, we undertook a study to investigate the potential correlation between serum Klotho and ACS patients. Method: This observational cohort study was conducted at Peking University People’s Hospital between May 2016 and April 2020. Upon admission, we collected the patients’ clinical data and conducted ELISA tests to measure their serum Klotho levels. Result: A total of 349 patients were enrolled in this study, including 14 patients with UA and 335 patients with AMI. We observed that serum Klotho levels were obviously higher in the AMI group compared to the UA group (median 479.8 vs. 233.8 pg/mL, p = 0.035). In addition, serum Klotho levels were positively correlated with cardiac function and more pronounced in patients who died in the hospital (median 721.1 vs. 468.3 pg/mL, p < 0.001). A logistic regression analysis indicated that age ≥ 78 years old, HR ≥ 90 bpm, Killip classification ≥ 3 grade, and serum Klotho > 645.0 pg/mL were risk factors for poor prognosis. Conclusions: Serum Klotho is obviously increased in patients with AMI and with a positive correlation with cardiac function, and its elevation could serve as a predictor of poor prognosis in ACS patients.

The relationship between total caffeine intake (TCI) and aging remains understudied. α-Klotho (KL), a key aging-related circulating biomarker, is clinically valuable. Unlike prior studies focusing on coffee intake, we analyzed TCI (from diet and supplements) to isolate its independent association with KL and explore mechanisms via molecular docking. We thus conducted a cross-sectional analysis with NHANES 2007 to 2016 data to investigate TCI and serum KL levels in adults aged 40 to 79. Serum KL levels were determined using ELISA kits, while trained interviewers assessed TCI through 24-hour dietary recalls. Generalized linear regression models were employed to evaluate the correlation between TCI and serum KL levels. We utilized restricted cubic spline analysis to explore the dose–response relationship between the 2 factors. Subgroup analyses and molecular docking studies were also conducted to further understand the association. After adjusting for potential confounders, higher TCI was significantly associated with lower serum KL levels. In the fully adjusted model, compared to the lowest TCI group, KL levels decreased by −30.21 pg/mL (95% CI = −50.49 to −9.93 pg/mL) and −27.31 pg/mL (95% CI = −51.94 to −2.67 pg/mL) in the third and fourth groups, respectively, indicating a significant trend ( P for trend = .005). Restricted cubic spline analysis revealed a linear dose–response relationship ( P for nonlinearity = .362). Subgroup analyses showed that the negative correlation was more pronounced in participants aged < 60 years, those who were overweight/obese, and females. Molecular docking analysis suggested a direct interaction between caffeine and KL, with a binding energy of −5.299 kcal/mol, implying a stable interaction. These results suggest a potential pro-aging effect of caffeine. Further prospective studies and experimental validation are needed to clarify caffeine’s effects on KL. Notably, molecular docking indicates caffeine may interfere with α-Klotho immunoassay detection, emphasizing the need for caffeine abstinence before testing to enhance biomarker accuracy.

Sepsis is a serious systemic inflammatory response syndrome characterized by a high death rate and a perilous disease course. Therefore, prognostic assessment in the treatment of sepsis is crucial. This study aims to elucidate the relationship between albumin-corrected calcium (ACC) levels and the prognosis of sepsis patients. Data were obtained from the MIMIC-IV 2.2 database for patients with sepsis admitted to the intensive care unit (ICU). The primary outcome was the risk of all-cause mortality (ACM) within 30 days of ICU admission. The secondary outcome was the ICU length of stay (LOS). 6243 patients were included. Patients were divided into the low ACC group (ACC < 8.86) and the high ACC group (ACC ≥ 8.86). The restricted cubic spline curve indicated a linear association between ACC levels and 30-day risk of ACM (P for nonlinear = 0.343). Multivariate Cox regression showed that ACC was positively correlated with 30-day risk of ACM (hazard ratio (HR = 1.19, 95% confidence interval (CI): 1.12, 1.27). Results after PSM were consistent with those prior to matching. The KM survival curve indicated a significant survival difference across the low and high ACC groups ( p < 0.0001). Subgroup analyses demonstrated that the correlation between ACC levels and 30-day risk of ACM remained stable. The findings suggest that ACC levels are independently associated with the prognosis of sepsis patients. ACC may act as a novel biomarker for the prognosis of sepsis.

Sepsis-associated encephalopathy is a prevalent complication in the sepsis population, especially in patients in the intensive care unit (ICU). The relationship between the hemoglobin glycation index (HGI) and delirium in sepsis patients in the ICU is not yet clearly established. To investigate the relationship between HGI and delirium risk in sepsis patients admitted to the ICU. Retrospective cohort study. The data were extracted from the Medical Information Mart for Intensive Care IV 3.1 for the sepsis population in the ICU. The primary outcome was delirium occurrence in the ICU, whereas the secondary outcome was 30-day all-cause mortality (ACM) after ICU admission. The patients were stratified into tertiles according to HGI levels: T1 (HGI < -0.612), T2 (-0.612 ≤ HGI < 0.008), and T3 (HGI ≥ 0.008). The link of HGI to clinical outcomes in ICU patients was examined through logistic regression (LR), Cox proportional hazard models, and restricted cubic spline (RCS) and threshold effect analyses. The robustness of our findings was rated through subgroup analyses and interaction tests. In total, 3,744 patients were encompassed in the final analysis. The LR model showed that delirium risk in the T1 group was 67.7% higher than that in the T2 group [odds ratio (OR) = 1.677, 95% confidence interval (CI): 1.414, 1.992], while that in the T3 group was 24.8% higher than that in the T2 group (OR = 1.248, 95% CI: 1.048, 1.487). The Cox proportional hazard model indicated a 36.2% higher risk of 30-day ACM in T1 compared to T2 (hazard ratio = 1.362; 95% CI: 1.041-1.782). The RCS curve demonstrated an approximately U-shaped relation of HGI to delirium risk. The threshold effect analysis revealed an inflection point at HGI = -0.34. When HGI ≤ -0.34, each one-unit increase in HGI lowered the delirium risk by 36.2% (95% CI: 0.527-0.768). This study suggested an independent association between HGI and both delirium risk and short-term prognosis in particularly in patients admitted to the ICU. HGI may be used as a prognostic risk stratification biomarker.