Liu Yongkang, Wang Jiangchuan, Wei Zicheng, Wang Yu, Wu Minghua, Wang Jianhua, Chen Xiao, Chen Rong
Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
Encephalopathy Center, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China.
J Nutr Health Aging. 2024 Dec;28(12):100405. doi: 10.1016/j.jnha.2024.100405. Epub 2024 Nov 2.
Biological age may be more accurate than chronological age in determining chronic health outcomes. However, few studies have shown the association between biological age and acute ischemic stroke (AIS). In this study we showed the association between phenotypic age (PhenoAge) or accelerated aging and severity and disability in patients with AIS.
Retrospective study.
936 patients with AIS during January 2019 to July 2021 and 512 patients during June 2022 to July 2023 for a validation.
Stroke severity was evaluated based on the National Institute of Health stroke scale (NIHSS) questionnaire scale. Disability was evaluated by modified Rankin Scale. PhenoAge was calculated based on chronological age and 9 clinical chemistry biomarkers. Logistic regression analyses were applied to estimate the relationship between PhenoAge and the severity and disability.
PhenoAge (odds ratio [OR] = 1.03, 95% confidence interval [CI]: 1.0-1.04, for NIHSS ≥ 5; OR = 1.05, 95%CI: 1.03-1.07, for NIHSS ≥ 10) was independently associated with stroke severity. The probability of NIHSS ≥ 5 or NIHSS ≥ 10 was significantly increased in individuals with accelerated ageing versus individuals with no accelerated aging (age gap: OR = 1.79, 95%CI: 1.18-2.72; OR = 3.53, 95%CI: 1.60-7.77; phenotypically older vs. phenotypically younger: OR = 2.01, 95%CI: 1.21-3.35; OR = 3.69, 95%CI: 1.36-10.0). Similar trends was observed when accelerated aging was defined by residual discrepancies between PhenoAge and chronological age (OR = 1.02, 95%CI: 1.01-1.04, for NIHSS ≥ 5; OR = 1.05, 95%CI: 1.02-1.08, for NIHSS ≥ 10). The area under the curve of PhenoAge was higher than that of chronological age in identifying patients with NIHSS ≥ 5 (0.66, 95%CI:0.62-0.70 vs. 0.61, 95%CI: 0.58-0.65, p < 0.01) and NIHSS ≥ 10 (0.69, 95%CI:0.60-0.77 vs. 0.63, 95%CI: 0.55-0.72, p = 0.05). The probability of severe disability was significantly increased in individuals with accelerated aging versus individuals with no accelerated aging (age gap: OR = 2.87, 95%CI: 1.09-7.53; phenotypically older vs. phenotypically younger: 4.88 (1.20-19.88). Similar results were observed in the validation population.
PhenoAge or accelerated aging is associated with stroke severity and disability even after adjusting for chronological age.
在确定慢性健康结局方面，生物学年龄可能比实际年龄更准确。然而，很少有研究表明生物学年龄与急性缺血性卒中（AIS）之间的关联。在本研究中，我们展示了表型年龄（PhenoAge）或加速衰老与AIS患者的严重程度和残疾之间的关联。
回顾性研究。
2019年1月至2021年7月期间的936例AIS患者以及2022年6月至2023年7月期间的512例患者用于验证。
基于美国国立卫生研究院卒中量表（NIHSS）问卷量表评估卒中严重程度。通过改良Rankin量表评估残疾情况。PhenoAge基于实际年龄和9种临床化学生物标志物计算得出。应用逻辑回归分析来估计PhenoAge与严重程度和残疾之间的关系。
PhenoAge（比值比[OR]=1.03，95%置信区间[CI]：1.0 - 1.04，对于NIHSS≥5；OR = 1.05，95%CI：1.03 - 1.07，对于NIHSS≥10）与卒中严重程度独立相关。与未加速衰老的个体相比，加速衰老的个体中NIHSS≥5或NIHSS≥10的概率显著增加（年龄差距：OR = 1.79，95%CI：1.18 - 2.72；OR = 3.53，95%CI：1.60 - 7.77；表型年龄较大与表型年龄较小相比：OR = 2.01，95%CI：1.21 - 3.35；OR = 3.69，95%CI：1.36 - 10.0）。当通过PhenoAge与实际年龄之间的残余差异定义加速衰老时，观察到类似趋势（对于NIHSS≥5，OR = 1.02，95%CI：1.01 - 1.04；对于NIHSS≥10，OR = 1.05，95%CI：1.02 - 1.08）。在识别NIHSS≥5的患者时，PhenoAge的曲线下面积高于实际年龄（0.66，95%CI：0.62 - 0.70对0.61，95%CI：0.58 - 0.65，p < 0.01）以及NIHSS≥10的患者（0.69，95%CI：0.60 - 0.77对0.63，9%CI：0.55 - 0.72，p = 0.05）。与未加速衰老的个体相比，加速衰老的个体中严重残疾的概率显著增加（年龄差距：OR = 2.87，95%CI：1.09 - 7.53；表型年龄较大与表型年龄较小相比：4.88（1.20 - 19.88）。在验证人群中观察到类似结果。
即使在调整实际年龄后，PhenoAge或加速衰老仍与卒中严重程度和残疾相关。
