Zhao Yuxuan, Yang Haiming, Jiao Rong, Wang Yueqing, Xiao Meng, Song Mingyu, Yu Huan, Liao Chunxiao, Pang Yuanjie, Gao Wenjing, Huang Tao, Yu Canqing, Lv Jun, Li Shengxu, Qi Lu, Li Liming, Sun Dianjianyi
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China.
Precis Clin Med. 2024 Sep 16;7(3):pbae019. doi: 10.1093/pcmedi/pbae019. eCollection 2024 Sep.
This study aimed to find out whether phenotypic age could mediate the protective effects of a healthy lifestyle on mortality.
We included adult participants with available data for individual phenotypic age (PhenoAge) and Life's Essential 8 (LE8) scores from the National Health and Nutrition Examination Survey 2005-2010 (three cycles) and linked mortality records until 31 December 2019. Adjusted hazard ratios (HR) were estimated to evaluate the associations of PhenoAge and LE8 scores with all-cause and cardiovascular mortality risk. Mediation analyses were performed to estimate the proportional contribution of PhenoAge to the effect of LE8 on mortality risks.
A 1-year increment in PhenoAge was associated with a higher risk of all-cause (HR = 1.04 [95% confidence interval, 1.04-1.05]) and cardiovascular (HR = 1.04 [95% confidence interval, 1.04-1.05]) mortality, independent of chronological age, demographic characteristics, and disease history. High level of LE8 (score: 80-100) was associated with a 3.30-year younger PhenoAge. PhenoAge was estimated to mediate 36 and 22% of the effect of LE8 on all-cause and cardiovascular mortality, respectively (all < 0.001). As for single-metric scores of LE8, PhenoAge mediated 30%, 11%, 9%, and 7% of the effects of the healthy diet, smoking status, blood pressure, and physical activity on all-cause mortality risk, respectively (all < 0.05).
Adherence to LE8 recommendations slows phenotypic aging. PhenoAge could mediate the effect of LE8 on mortality risk.
本研究旨在探究表型年龄是否能介导健康生活方式对死亡率的保护作用。
我们纳入了来自2005 - 2010年国家健康与营养检查调查（三个周期）的成年参与者，这些参与者有关于个体表型年龄（PhenoAge）和生命必需8项（LE8）评分的可用数据，并将死亡率记录关联至2019年12月31日。估计调整后的风险比（HR）以评估PhenoAge和LE8评分与全因死亡率和心血管死亡率风险之间的关联。进行中介分析以估计PhenoAge对LE8对死亡风险影响的比例贡献。
PhenoAge每增加1岁与全因死亡率（HR = 1.04 [95%置信区间，1.04 - 1.05]）和心血管死亡率（HR = 1.04 [95%置信区间，1.04 - 1.05]）风险升高相关，独立于实足年龄、人口统计学特征和疾病史。高水平的LE8（评分：80 - 100）与年轻3.30岁的PhenoAge相关。据估计，PhenoAge分别介导了LE8对全因死亡率和心血管死亡率影响的36%和22%（均P < 0.001）。至于LE8的单项指标评分，PhenoAge分别介导了健康饮食、吸烟状况、血压和身体活动对全因死亡风险影响的30%、11%、9%和7%（均P < 0.05）。
坚持LE8建议可减缓表型衰老。PhenoAge可介导LE8对死亡风险的影响。
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