Wang Sicong, Wen Chi Pang, Li Wenyuan, Li Shu, Sun Mingxi, Xu Andi, Tsai Min Kuang, Chu David Ta-Wei, Tsai Shan Pou, Tu Huakang, Wu Xifeng
Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Alibaba-Zhejiang University Joint Research Center of Future Digital Healthcare, Hangzhou, Zhejiang, China.
J Gerontol A Biol Sci Med Sci. 2023 Mar 30;78(4):690-697. doi: 10.1093/gerona/glac161.
Although biological aging has been proposed as a more accurate measure of aging, few biological aging measures have been developed for Asians, especially for young adults.
A total of 521 656 participants were enrolled in the MJ cohort (1996-2011) and were followed until death, loss-to-follow-up, or December 31, 2011, whichever came first. We selected 14 clinical biomarkers, including chronological age, using a random forest algorithm, and developed a multidimensional aging measure (MDAge). Model performance was assessed by area under the curve (AUC) and internal calibration. We evaluated the associations of MDAge and residuals from regressing MDAge on chronological age (MDAgeAccel) with mortality and morbidity, and assessed the robustness of our findings.
MDAge achieved an excellent AUC of 0.892 in predicting all-cause mortality (95% confidence interval [CI]: 0.889-0.894). Participants with higher MDAge at baseline were at a higher risk of death (per 5 years, hazard ration [HR] = 1.671, 95% CI: 1.662-1.680), and the association remained after controlling for other variables and in different subgroups. Furthermore, participants with higher MDAgeAccel were associated with shortened life expectancy. For instance, compared to men who were biologically younger (MDAgeAccel ≤ 0) at baseline, men in the highest tertiles of MDAgeAccel had shortened life expectancy by 17.23 years. In addition, higher MDAgeAccel was associated with having chronic disease either cross-sectionally (per 1-standard deviation [SD], odds ratio [OR] = 1.564, 95% CI: 1.552-1.575) or longitudinally (per 1-SD, OR = 1.218, 95% CI: 1.199-1.238).
MDAge accurately predicted mortality and morbidity, which has great potential in the early identification of individuals at higher risk and therefore promoting early intervention.
尽管生物衰老被认为是一种更准确的衰老衡量指标，但针对亚洲人，尤其是年轻成年人开发的生物衰老衡量指标却很少。
共有521656名参与者纳入MJ队列研究（1996 - 2011年），并随访至死亡、失访或2011年12月31日，以先发生者为准。我们使用随机森林算法选择了14种临床生物标志物，包括实足年龄，并开发了一种多维衰老衡量指标（MDAge）。通过曲线下面积（AUC）和内部校准评估模型性能。我们评估了MDAge以及将MDAge回归到实足年龄后的残差（MDAgeAccel）与死亡率和发病率之间的关联，并评估了研究结果的稳健性。
MDAge在预测全因死亡率方面的AUC达到了出色的0.892（95%置信区间[CI]：0.889 - 0.894）。基线时MDAge较高的参与者死亡风险更高（每5年，风险比[HR] = 1.671，95% CI：1.662 - 1.680），在控制其他变量后以及在不同亚组中该关联依然存在。此外，MDAgeAccel较高的参与者预期寿命缩短。例如，与基线时生物年龄较小（MDAgeAccel≤0）的男性相比，MDAgeAccel最高三分位数的男性预期寿命缩短了17.23年。此外，较高的MDAgeAccel在横断面研究中（每1个标准差[SD]，优势比[OR] = 1.564，95% CI：1.552 - 1.575）或纵向研究中（每1个标准差，OR = 1.218，95% CI：1.199 - 1.238）均与患有慢性病相关。
MDAge能准确预测死亡率和发病率，在早期识别高风险个体并因此促进早期干预方面具有巨大潜力。
