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Physical activity clearly reduces disease-specific mortality in patients with diabetes.1The 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 calcifications 2 ,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. 6Reduced plasma levels of klotho are found in elderly persons, and klotho deficient mice display an ageing …
Contributors AS-D, BM, MCO-J and RPV performed the experiments and analysed the data. RPV designed the study. RMM, FMC-C and RPV wrote and reviewed the manuscript.
Funding São Paulo Research Foundation (FAPESP). 2012/15165-2, 2014/14604-8, 2014/23196-0.
Competing interests None declared.
Ethics approval This study was approved by the local Ethical Committee from Nove de Julho University, under registration number 43554415.4.0000.5511.
Provenance and peer review Not commissioned; externally peer reviewed.