Association between cigarette smoking and serum alpha klotho levels among US adults over 40-years-old: a cross-sectional study

Alpha klotho (alpha-Klotho) is an anti-aging molecule associated with aging and several diseases. Previous studies have reported inconsistent levels of alpha-Klotho in smokers. This study aimed to demonstrate serum alpha-Klotho levels in smokers among the US population. This cross-sectional study recruited 11,559 participants (aged 40-79 years; 48.2% males). All data were collected from the 2007-2016 National Health and Nutrition Examination Survey. The study comprised adults with reliable Klotho and smoking questionnaire results. The relationship between smoking and serum alpha-klotho levels was assessed using multivariate linear regression models after adjusting for potential confounders. We also performed a stratified analysis of clinically important variables. The mean serum alpha-klotho level among the 11,559 participants was 843.85 pg/mL. After full adjustment, habitual smoking was significantly associated with decreased serum levels of alpha-klotho level (beta = - 34.89; 95% CI - 54.97, - 14.81; P = 0.0013) in the total study population. Furthermore, the stratified analysis indicated that the association was insignificant in the 60-79 age group. Quitting smoking was not significantly associated with serum levels of alpha-klotho as expected (P = 0.1148) in the total study population. However, stratified analyses showed a significant inversed association in the male, those with chronic kidney disease, or those with cancer who quit smoking (all P < 0.05). Cigarette smoking was inversely associated with serum alpha-Klotho levels among US adults.