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Physical activity clearly reduces disease-specific mortality in patients with diabetes.1 The mechanism responsible for reduced mortality appears to be linked to exercise-induced improvement in oxidation and reduction (redox) responses, as well as the halting or reversal of arterial and venal calcifications2 ,3 in diabetes-associated cardiovascular diseases (CVD)—currently the world's leading cause of mortality.4 A recent review established a relationship between decreased bioavailability of the protein klotho with CVD and with chronic kidney disease (CKD) disease states.5 Reduced levels of klotho are related to CVD and CKD complications, involving vascular calcification, inflammation, endothelial dysfunction and redox imbalance.5
Klotho is primarily expressed in the kidneys, but also found in other organs as well as cerebrospinal fluid, urine and blood.6 Reduced plasma levels of klotho are found in elderly persons, and klotho deficient mice display …
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