Biological ageing and the risks of all-cause and cause-specific mortality among people with diabetes: a prospective cohort study

医学 老化 糖尿病 比例危险模型 危险系数 内科学 人口 队列 疾病 前瞻性队列研究 队列研究 死因 生物年龄 2型糖尿病 病因学 老年学 人口学 内分泌学 环境卫生 置信区间 社会学
作者
Li Chen,Xingzhu Yin,Ying Zhao,Huimin Chen,Tianqi Tan,Ping Yao,Yuhan Tang
出处
期刊:Journal of Epidemiology and Community Health [BMJ]
卷期号:76 (9): 771-778 被引量:40
标识
DOI:10.1136/jech-2022-219142
摘要

Background The aetiology of diabetes is complex with limited treatment strategies. Growing animal studies have shown that targeted antiageing can improve the outcomes of diabetes. However, population evidence is limited. This study aims to evaluate the associations of biological ageing with all-cause and cause-specific mortality among people with diabetes. Methods A total of 5278 people with diabetes from the National Health and Nutrition Examination Survey 1999–2014 were included. Biological ageing was measured from different perspectives, including phenotypic age, biological age, telomere length and klotho concentration. Phenotypic/biological age acceleration was the residual resulting from a linear model when regressing phenotypic/biological age on chronological age. Cox proportional hazards models were used to examine the relationships between ageing and all-cause, cardiovascular disease (CVD), and cancer mortality. Results Over median follow-up for 7.3 years, 1355 diabetics died. There was a positive and linear association of mortality with phenotypic age acceleration (HR all-cause 1.04; HR CVD 1.04; HR cancer 1.04, p<0.001) and biological age acceleration (HR all-cause 1.03; HR CVD 1.04; HR cancer 1.03, p<0.001). Telomere length was inversely associated with all-cause mortality (tertile (T)3 vs T1: HR 0.67, p<0.05). The concentration of klotho had a U-shaped relationship with mortality (T2 vs T1: HR all-cause 0.62; HR CVD 0.48; HR cancer 0.47, p<0.05). Further, stratified analysis by age and sex found that the associations of ageing-related markers with mortality were more significant in the aged and female subgroup. Conclusions Biological ageing was positively associated with mortality among people with diabetes, indicating therapies targeting antiageing could be encouraged to halt the progression of diabetes.
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