1  4249 140 METHYLATION-BASED BIOLOGICAL AGE AND BREAST CANCER RISK. BACKGROUND: AGE IS ONE OF THE STRONGEST PREDICTORS OF CANCER, CHRONIC DISEASE, AND MORTALITY, BUT BIOLOGICAL RESPONSES TO AGING DIFFER AMONG PEOPLE. EPIGENETIC DNA MODIFICATIONS HAVE BEEN USED TO ESTIMATE "BIOLOGICAL AGE," WHICH MAY BE A USEFUL PREDICTOR OF DISEASE RISK. WE TESTED THIS HYPOTHESIS FOR BREAST CANCER. METHODS: USING A CASE-COHORT APPROACH, WE MEASURED BASELINE BLOOD DNA METHYLATION OF 2764 WOMEN ENROLLED IN THE SISTER STUDY, 1566 OF WHOM SUBSEQUENTLY DEVELOPED BREAST CANCER AFTER AN AVERAGE OF 6 YEARS. USING THREE PREVIOUSLY ESTABLISHED METHYLATION-BASED "CLOCKS" (HANNUM, HORVATH, AND LEVINE), WE DEFINED BIOLOGICAL AGE ACCELERATION FOR EACH WOMAN BY COMPARING HER ESTIMATED BIOLOGICAL AGE WITH HER CHRONOLOGICAL AGE. HAZARD RATIOS AND 95% CONFIDENCE INTERVALS FOR BREAST CANCER RISK WERE ESTIMATED USING COX REGRESSION MODELS. ALL STATISTICAL TESTS WERE TWO-SIDED. RESULTS: EACH OF THE THREE CLOCKS SHOWED THAT BIOLOGICAL AGE ACCELERATION WAS STATISTICALLY SIGNIFICANTLY ASSOCIATED WITH INCREASED RISK OF DEVELOPING BREAST CANCER (5-YEAR AGE ACCELERATION, HANNUM'S CLOCK: HAZARD RATIO [HR] = 1.10, 95% CONFIDENCE INTERVAL [CI] = 1.00 TO 1.21, P = .04; HORVATH'S CLOCK: HR = 1.08, 95% CI = 1.00 TO 1.17, P = .04; LEVINE'S CLOCK: HR = 1.15, 95% CI = 1.07 TO 1.23, P < .001). FOR LEVINE'S CLOCK, EACH 5-YEAR ACCELERATION IN BIOLOGICAL AGE CORRESPONDED WITH A 15% INCREASE IN BREAST CANCER RISK. ALTHOUGH BIOLOGICAL AGE MAY ACCELERATE WITH MENOPAUSAL TRANSITION, AGE ACCELERATION IN PREMENOPAUSAL WOMEN INDEPENDENTLY PREDICTED BREAST CANCER. CASE-ONLY ANALYSIS SUGGESTED THAT, AMONG WOMEN WHO DEVELOP BREAST CANCER, INCREASED AGE ACCELERATION IS ASSOCIATED WITH INVASIVE CANCER (ODDS RATIO FOR INVASIVE = 1.09, 95% CI = 0.98 TO 1.22, P = .10). CONCLUSIONS: DNA METHYLATION-BASED MEASURES OF BIOLOGICAL AGE MAY BE IMPORTANT PREDICTORS OF BREAST CANCER RISK.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
2   624  46 BIOLOGICAL AGE ACCELERATION AND MOTORIC COGNITIVE RISK SYNDROME. OBJECTIVE: MOTORIC COGNITIVE RISK (MCR) SYNDROME, A PREDEMENTIA SYNDROME CHARACTERIZED BY SLOW GAIT AND SUBJECTIVE COGNITIVE CONCERNS, IS ASSOCIATED WITH MULTIPLE AGE-RELATED RISK FACTORS. WE HYPOTHESIZED THAT MCR IS ASSOCIATED WITH BIOLOGICAL AGE ACCELERATION. WE EXAMINED THE ASSOCIATIONS OF BIOLOGICAL AGE ACCELERATION WITH MCR, AND MORTALITY RISK IN MCR CASES. METHODS: BIOLOGICAL AGE WAS DETERMINED USING PROTEOMIC AND EPIGENETIC CLOCKS IN PARTICIPANTS AGED 65 YEARS AND OLDER IN THE LONGENITY STUDY (N = 700, FEMALES = 57.9%) AND HEALTH AND RETIREMENT STUDY (HRS; N = 1,043, FEMALES = 57.1%) COHORTS. AGE ACCELERATION (AGEACCEL) WAS OPERATIONALLY DEFINED AS THE RESIDUAL FROM REGRESSING PREDICTED BIOLOGICAL AGE (FROM BOTH CLOCKS SEPARATELY) ON CHRONOLOGICAL AGE. ASSOCIATION OF AGEACCEL WITH INCIDENT MCR IN THE OVERALL SAMPLE AS WELL AS WITH MORTALITY RISK IN MCR CASES WAS EXAMINED USING COX MODELS AND REPORTED AS HAZARD RATIOS (HRS). RESULTS: AGEACCEL SCORES DERIVED FROM A PROTEOMIC CLOCK WERE ASSOCIATED WITH PREVALENT MCR (ODDS RATIO ADJUSTED FOR AGE, GENDER, EDUCATION YEARS, AND CHRONIC ILLNESSES [AOR] = 1.36, 95% CONFIDENCE INTERVAL [CI] = 1.09-1.71) AS WELL AS PREDICTED INCIDENT MCR (HR = 1.19, 95% CI = 1.00-1.41) IN THE LONGENITY COHORT. IN HRS, THE ASSOCIATION OF AGEACCEL USING AN EPIGENETIC CLOCK WITH PREVALENT MCR WAS CONFIRMED (AOR = 1.47, 95% CI = 1.16-1.85). PARTICIPANTS WITH MCR AND ACCELERATED AGING (POSITIVE AGEACCEL SCORE) WERE AT THE HIGHEST RISK FOR MORTALITY IN BOTH LONGENITY (HR = 3.38, 95% CI = 2.01-5.69) AND HRS (HR = 2.47, 95% CI = 1.20-5.10). INTERPRETATION: ACCELERATED AGING PREDICTS RISK FOR MCR, AND IS ASSOCIATED WITH HIGHER MORTALITY IN MCR PATIENTS. ANN NEUROL 2023;93:1187-1197.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
3  1305  28 DEFICIENT H2A.Z DEPOSITION IS ASSOCIATED WITH GENESIS OF UTERINE LEIOMYOMA. ONE IN FOUR WOMEN SUFFERS FROM UTERINE LEIOMYOMAS (ULS)-BENIGN TUMOURS OF THE UTERINE WALL, ALSO KNOWN AS UTERINE FIBROIDS-AT SOME POINT IN PREMENOPAUSAL LIFE. ULS CAN CAUSE EXCESSIVE BLEEDING, PAIN AND INFERTILITY(1), AND ARE A COMMON CAUSE OF HYSTERECTOMY(2). THEY EMERGE THROUGH AT LEAST THREE DISTINCT GENETIC DRIVERS: MUTATIONS IN MED12 OR FH, OR GENOMIC REARRANGEMENT OF HMGA2(3). HERE WE CREATED GENOME-WIDE DATASETS, USING DNA, RNA, ASSAY FOR TRANSPOSASE-ACCESSIBLE CHROMATIN (ATAC), CHROMATIN IMMUNOPRECIPITATION (CHIP) AND HIC CHROMATIN IMMUNOPRECIPITATION (HICHIP) SEQUENCING OF PRIMARY TISSUES TO PROFOUNDLY UNDERSTAND THE GENESIS OF UL. WE IDENTIFIED SOMATIC MUTATIONS IN GENES ENCODING SIX MEMBERS OF THE SRCAP HISTONE-LOADING COMPLEX(4), AND FOUND THAT GERMLINE MUTATIONS IN THE SRCAP MEMBERS YEATS4 AND ZNHIT1 PREDISPOSE WOMEN TO UL. TUMOURS BEARING THESE MUTATIONS SHOWED DEFECTIVE DEPOSITION OF THE HISTONE VARIANT H2A.Z. IN ULS, H2A.Z OCCUPANCY CORRELATED POSITIVELY WITH CHROMATIN ACCESSIBILITY AND GENE EXPRESSION, AND NEGATIVELY WITH DNA METHYLATION, BUT THESE CORRELATIONS WERE WEAK IN TUMOURS BEARING SRCAP COMPLEX MUTATIONS. IN THESE TUMOURS, OPEN CHROMATIN EMERGED AT TRANSCRIPTION START SITES WHERE H2A.Z WAS LOST, WHICH WAS ASSOCIATED WITH UPREGULATION OF GENES. FURTHERMORE, YEATS4 DEFECTS WERE ASSOCIATED WITH ABNORMAL UPREGULATION OF BIVALENT EMBRYONIC STEM CELL GENES, AS PREVIOUSLY SHOWN IN MICE(5). OUR WORK DESCRIBES A POTENTIAL MECHANISM OF TUMORIGENESIS-EPIGENETIC INSTABILITY CAUSED BY DEFICIENT H2A.Z DEPOSITION-AND SUGGESTS THAT ULS ARISE THROUGH AN ABERRANT DIFFERENTIATION PROGRAM DRIVEN BY DERANGED CHROMATIN, EMANATING FROM A SMALL NUMBER OF MUTUALLY EXCLUSIVE DRIVER MUTATIONS.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
4  1746  44 EARLY LIFE ADVERSITY, PUBERTAL TIMING, AND EPIGENETIC AGE ACCELERATION IN ADULTHOOD. BACKGROUND: GIVEN ASSOCIATIONS LINKING EARLY LIFE ADVERSITY, PUBERTAL TIMING, AND BIOLOGICAL AGING, WE EXAMINED THE DIRECT AND INDIRECT EFFECTS OF EARLY LIFE TRAUMA ON ADULT BIOLOGICAL AGING (VIA AGE OF MENARCHE). METHODS: PARTICIPANTS WERE PREMENOPAUSAL WOMEN (N = 183). PATH MODELS EVALUATED WHETHER EARLY LIFE TRAUMA PREDICTED EARLY PUBERTAL TIMING AND THEREBY, ADULT EPIGENETIC AGE ACCELERATION (INDEXED VIA FOUR EPIGENETIC CLOCKS: HORVATH DNAM AGE, HANNUM DNAM AGE, DNAM PHENOAGE, AND DNAM GRIMAGE). SECONDARY ANALYSES EXPLORED THE EFFECTS OF TYPE OF TRAUMA (ABUSE AND NEGLECT) AND ADULT CHRONIC STRESS STATUS (CAREGIVER OF CHILD WITH AUTISM AND NON-CAREGIVER). RESULTS: EARLY LIFE TRAUMA AND EARLIER AGE AT MENARCHE INDEPENDENTLY PREDICTED ACCELERATED AGING BASED ON ONE OF THE FOUR EPIGENETIC CLOCKS, DNAM GRIMAGE, THOUGH EARLY LIFE TRAUMA WAS NOT ASSOCIATED WITH AGE OF MENARCHE. CHILDHOOD ABUSE, BUT NOT NEGLECT, PREDICTED FASTER EPIGENETIC AGING; RESULTS DID NOT DIFFER BY CHRONIC STRESS STATUS. CONCLUSIONS: EARLY TRAUMA AND EARLY MENARCHE APPEAR TO EXERT INDEPENDENT EFFECTS ON DNAM GRIMAGE, WHICH HAS BEEN SHOWN TO BE THE STRONGEST EPIGENETIC PREDICTOR OF MORTALITY RISK. THIS STUDY IDENTIFIES A POTENTIAL CORRELATE OR DETERMINANT OF ACCELERATED EPIGENETIC AGING-MENARCHEAL AGE. FUTURE RESEARCH SHOULD ADDRESS THE LIMITATIONS OF THIS STUDY BY USING RACIALLY DIVERSE SAMPLES.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5   525  46 ASSOCIATIONS OF BODY COMPOSITION AND PHYSICAL ACTIVITY LEVEL WITH MULTIPLE MEASURES OF EPIGENETIC AGE ACCELERATION. EPIGENETIC CLOCKS USE DNA METHYLATION TO ESTIMATE BIOLOGICAL AGE. WHETHER BODY COMPOSITION AND PHYSICAL ACTIVITY ARE ASSOCIATED WITH THESE CLOCKS IS NOT WELL UNDERSTOOD. USING BLOOD SAMPLES COLLECTED AT ENROLLMENT (2003-2009) FROM 2,758 WOMEN IN THE US NATIONWIDE SISTER STUDY, WE CALCULATED 6 EPIGENETIC AGE ACCELERATION METRICS USING 4 EPIGENETIC CLOCKS (HANNUM, HORVATH, PHENOAGE, GRIMAGE). RECREATIONAL PHYSICAL ACTIVITY WAS SELF-REPORTED, AND ADIPOSITY MEASURES WERE ASSESSED BY TRAINED MEDICAL EXAMINERS (BODY MASS INDEX (BMI), WAIST-TO-HIP RATIO (WTH), WAIST CIRCUMFERENCE). IN CROSS-SECTIONAL ANALYSES, ALL ADIPOSITY MEASURES WERE ASSOCIATED WITH EPIGENETIC AGE ACCELERATION. THE STRONGEST ASSOCIATION WAS FOR BMI AND PHENOAGE, A MEASURE OF BIOLOGICAL AGE THAT CORRELATES WITH CHRONIC DISEASE (BMI OF >/=35.0 VS. 18.5-24.9, BETA = 3.15 YEARS, 95% CONFIDENCE INTERVAL (CI): 2.41, 3.90; P FOR TREND < 0.001). IN A MUTUAL-ADJUSTMENT MODEL, BOTH WERE ASSOCIATED WITH PHENOAGE AGE ACCELERATION (BMI OF >/=35.0 VS. 18.5-24.9, BETA = 2.69 YEARS, 95% CI: 1.90, 3.48; P FOR TREND < 0.001; QUARTILE 4 VS.1 WTH, BETA = 1.00 YEARS, 95% CI: 0.34, 1.65; P FOR TREND < 0.008). AFTER ADJUSTMENT, PHYSICAL ACTIVITY WAS ASSOCIATED ONLY WITH GRIMAGE (QUARTILE 4 VS. 1, BETA = -0.42 YEARS, 95% CI: -0.70, -0.14; P FOR TREND = 0.001). PHYSICAL ACTIVITY ATTENUATED THE WAIST CIRCUMFERENCE ASSOCIATIONS WITH PHENOAGE AND GRIMAGE. EXCESS ADIPOSITY WAS ASSOCIATED WITH EPIGENETIC AGE ACCELERATION; PHYSICAL ACTIVITY MIGHT ATTENUATE ASSOCIATIONS WITH WAIST CIRCUMFERENCE.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
6  3579  46 IMPACT OF PATERNAL EDUCATION ON EPIGENETIC AGEING IN ADOLESCENCE AND MID-ADULTHOOD: A MULTI-COHORT STUDY IN THE USA AND MEXICO. BACKGROUND: BOTH PARENTAL AND NEIGHBOURHOOD SOCIO-ECONOMIC STATUS (SES) ARE LINKED TO POORER HEALTH INDEPENDENTLY OF PERSONAL SES MEASURES, BUT THE BIOLOGICAL MECHANISMS ARE UNCLEAR. OUR OBJECTIVE WAS TO EXAMINE THESE INFLUENCES VIA EPIGENETIC AGE ACCELERATION (EAA)-THE DISCREPANCY BETWEEN CHRONOLOGICAL AND EPIGENETIC AGES. METHODS: WE EXAMINED THREE USA-BASED [CORONARY ARTERY RISK DISEASE IN ADULTS (CARDIA) STUDY, FRAGILE FAMILIES AND CHILD WELLBEING STUDY (FFCWS) AND PROGRAMMING RESEARCH IN OBESITY, GROWTH, ENVIRONMENT AND SOCIAL STRESSORS (PROGRESS)] AND ONE MEXICO-BASED (PROJECT VIVA) COHORT. DNA METHYLATION WAS MEASURED USING ILLUMINA ARRAYS, PERSONAL/PARENTAL SES BY QUESTIONNAIRE AND NEIGHBOURHOOD DISADVANTAGE FROM GEOCODED ADDRESS. IN CARDIA, WE EXAMINED THE MOST STRONGLY ASSOCIATED PERSONAL, PARENTAL AND NEIGHBOURHOOD SES MEASURES WITH EAA (HANNUM'S METHOD) AT STUDY YEARS 15 AND 20 SEPARATELY AND COMBINED USING A GENERALIZED ESTIMATING EQUATION (GEE) AND COMPARED WITH OTHER EAA MEASURES (HORVATH'S EAA, PHENOAGE AND GRIMAGE CALCULATORS, AND DUNEDINPOAM). RESULTS: EAA WAS ASSOCIATED WITH PATERNAL EDUCATION IN CARDIA [GEES: BETASOME COLLEGE = -1.01 YEARS (-1.91, -0.11) AND BETA<HIGH SCHOOL = 1.05 (0.09, 2.01) VS COLLEGE GRADUATES] AND FFCWS [GEES: BETA<HIGH SCHOOL = 0.62 (0.00, 1.24)]. WE FOUND STRONGER ASSOCIATIONS FOR SOME PATERNAL EDUCATION CATEGORIES AMONG WHITE ADULTS (FOR GEE, BETASOME COLLEGE = -1.39 (-2.41, -0.38)], MEN (BETASOME COLLEGE = -1.76 (-3.16, -0.35)] AND WOMEN [BETA<HIGH SCHOOL = 1.77 (0.42, 3.11)]. CONCLUSIONS: THESE FINDINGS SUGGEST THAT EAA CAPTURES EPIGENETIC IMPACTS OF PATERNAL EDUCATION INDEPENDENTLY OF PERSONAL SES LATER IN LIFE. LONGITUDINAL STUDIES SHOULD EXPLORE THESE ASSOCIATIONS AT DIFFERENT LIFE STAGES AND LINK THEM TO HEALTH OUTCOMES. EAA COULD BE A USEFUL BIOMARKER OF SES-ASSOCIATED HEALTH AND PROVIDE IMPORTANT INSIGHT INTO THE PATHOGENESIS AND PREVENTION OF CHRONIC DISEASE.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
7  1955  61 EPIGENETIC AGE ACCELERATION PREDICTS CANCER, CARDIOVASCULAR, AND ALL-CAUSE MORTALITY IN A GERMAN CASE COHORT. BACKGROUND: PREVIOUS STUDIES HAVE DEVELOPED MODELS PREDICTING METHYLATION AGE FROM DNA METHYLATION IN BLOOD AND OTHER TISSUES (EPIGENETIC CLOCK) AND SUGGESTED THE DIFFERENCE BETWEEN DNA METHYLATION AND CHRONOLOGICAL AGES AS A MARKER OF HEALTHY AGING. THE GOAL OF THIS STUDY WAS TO CONFIRM AND EXPAND SUCH OBSERVATIONS BY INVESTIGATING WHETHER DIFFERENT CONCEPTS OF THE EPIGENETIC CLOCKS IN A POPULATION-BASED COHORT ARE ASSOCIATED WITH CANCER, CARDIOVASCULAR, AND ALL-CAUSE MORTALITY. RESULTS: DNA METHYLATION AGE WAS ESTIMATED IN A COHORT OF 1863 OLDER PEOPLE, AND THE DIFFERENCE BETWEEN AGE PREDICTED BY DNA METHYLATION AND CHRONOLOGICAL AGE (DELTAAGE) WAS CALCULATED. A CASE-COHORT DESIGN AND WEIGHTED PROPORTIONAL COX HAZARD MODELS WERE USED TO ESTIMATE ASSOCIATIONS OF DELTAAGE WITH CANCER, CARDIOVASCULAR, AND ALL-CAUSE MORTALITY. HAZARD RATIOS FOR DELTAAGE (PER 5 YEARS) CALCULATED USING THE EPIGENETIC CLOCK DEVELOPED BY HORVATH WERE 1.23 (95 % CI 1.10-1.38) FOR ALL-CAUSE MORTALITY, 1.22 (95 % CI 1.03-1.45) FOR CANCER MORTALITY, AND 1.19 (95 % CI 0.98-1.43) FOR CARDIOVASCULAR MORTALITY AFTER ADJUSTMENT FOR BATCH EFFECTS, AGE, SEX, EDUCATIONAL LEVEL, HISTORY OF CHRONIC DISEASES, HYPERTENSION, SMOKING STATUS, BODY MASS INDEX, AND LEUCOCYTE DISTRIBUTION. ASSOCIATIONS WERE SIMILAR BUT WEAKER FOR DELTAAGE CALCULATED USING THE EPIGENETIC CLOCK DEVELOPED BY HANNUM. CONCLUSIONS: THESE RESULTS SHOW THAT AGE ACCELERATION IN TERMS OF THE DIFFERENCE BETWEEN AGE PREDICTED BY DNA METHYLATION AND CHRONOLOGICAL AGE IS AN INDEPENDENT PREDICTOR OF ALL-CAUSE AND CAUSE-SPECIFIC MORTALITY AND MAY BE USEFUL AS A GENERAL MARKER OF HEALTHY AGING.	2016	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
8  1645  60 DOES THE EPIGENETIC CLOCK GRIMAGE PREDICT MORTALITY INDEPENDENT OF GENETIC INFLUENCES: AN 18 YEAR FOLLOW-UP STUDY IN OLDER FEMALE TWIN PAIRS. BACKGROUND: EPIGENETIC CLOCKS ARE BASED ON DNA METHYLATION (DNAM). IT HAS BEEN SUGGESTED THAT THESE CLOCKS ARE USEABLE MARKERS OF BIOLOGICAL AGING AND PREMATURE MORTALITY. BECAUSE GENETIC FACTORS EXPLAIN VARIATIONS IN BOTH EPIGENETIC AGING AND MORTALITY, THIS ASSOCIATION COULD ALSO BE EXPLAINED BY SHARED GENETIC FACTORS. WE INVESTIGATED THE INFLUENCE OF GENETIC AND LIFESTYLE FACTORS (SMOKING, ALCOHOL CONSUMPTION, PHYSICAL ACTIVITY, CHRONIC DISEASES, BODY MASS INDEX) AND EDUCATION ON THE ASSOCIATION OF ACCELERATED EPIGENETIC AGING WITH MORTALITY USING A LONGITUDINAL TWIN DESIGN. UTILIZING A PUBLICLY AVAILABLE ONLINE TOOL, WE CALCULATED THE EPIGENETIC AGE USING TWO EPIGENETIC CLOCKS, HORVATH DNAMAGE AND DNAM GRIMAGE, IN 413 FINNISH TWIN SISTERS, AGED 63-76 YEARS, AT THE BEGINNING OF THE 18-YEAR MORTALITY FOLLOW-UP. EPIGENETIC AGE ACCELERATION WAS CALCULATED AS THE RESIDUALS FROM A LINEAR REGRESSION MODEL OF EPIGENETIC AGE ESTIMATED ON CHRONOLOGICAL AGE (AA(HORVATH), AA(GRIMAGE), RESPECTIVELY). COX PROPORTIONAL HAZARD MODELS WERE CONDUCTED FOR INDIVIDUALS AND TWIN PAIRS. RESULTS: THE RESULTS OF THE INDIVIDUAL-BASED ANALYSES SHOWED AN INCREASED MORTALITY HAZARD RATIO (HR) OF 1.31 (CI(95): 1.13-1.53) PER ONE STANDARD DEVIATION (SD) INCREASE IN AA(GRIMAGE). THE RESULTS INDICATED NO SIGNIFICANT ASSOCIATIONS OF AA(HORVATH) WITH MORTALITY. PAIRWISE MORTALITY ANALYSES SHOWED AN HR OF 1.50 (CI(95): 1.02-2.20) PER 1 SD INCREASE IN AA(GRIMAGE). HOWEVER, AFTER ADJUSTING FOR SMOKING, THE HR ATTENUATED SUBSTANTIALLY AND WAS STATISTICALLY NON-SIGNIFICANT (1.29; CI(95): 0.84-1.99). SIMILARLY, IN MULTIVARIABLE ADJUSTED MODELS THE HR (1.42-1.49) WAS NON-SIGNIFICANT. IN AA(HORVATH), THE NON-SIGNIFICANT HRS WERE LOWER AMONG MONOZYGOTIC PAIRS IN COMPARISON TO DIZYGOTIC PAIRS, WHILE IN AA(GRIMAGE) THERE WERE NO SYSTEMATIC DIFFERENCES BY ZYGOSITY. FURTHER, THE PAIRWISE ANALYSIS IN QUARTILES SHOWED THAT THE INCREASED WITHIN PAIR DIFFERENCE IN AA(GRIMAGE) WAS ASSOCIATED WITH A HIGHER ALL-CAUSE MORTALITY RISK. CONCLUSIONS: IN CONCLUSION, THE FINDINGS SUGGEST THAT DNAM GRIMAGE IS A STRONG PREDICTOR OF MORTALITY INDEPENDENT OF GENETIC INFLUENCES. SMOKING, WHICH IS KNOWN TO ALTER DNAM LEVELS AND IS BUILT INTO THE DNAM GRIMAGE ALGORITHM, ATTENUATED THE ASSOCIATION BETWEEN EPIGENETIC AGING AND MORTALITY RISK.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
9  1953  45 EPIGENETIC AGE ACCELERATION AND CHRONIC HEALTH CONDITIONS AMONG ADULT SURVIVORS OF CHILDHOOD CANCER. BACKGROUND: MOUNTING EVIDENCE SUPPORTS THE OCCURRENCE OF ACCELERATING AGING AMONG LONG-TERM SURVIVORS OF CHILDHOOD CANCER. WE AIMED TO INVESTIGATE EPIGENETIC AGE ACCELERATION (EAA) IN SURVIVORS AND EVALUATE ASSOCIATIONS BETWEEN EAA, TREATMENT EXPOSURES, HEALTH BEHAVIORS, AND CHRONIC HEALTH CONDITIONS (CHCS). METHODS: GENOME-WIDE METHYLATION DATA WERE GENERATED WITH INFINIUM EPIC BEADCHIP ON BLOOD-DERIVED DNA FROM 2139 SURVIVORS AND 282 FREQUENCY MATCHED CONTROLS FROM THE ST JUDE LIFETIME COHORT STUDY. EAAS WERE ESTIMATED AS RESIDUALS FROM A LINEAR REGRESSION OF EPIGENETIC AGE (LEVINE'S CLOCK) AGAINST CHRONOLOGICAL AGE. ADJUSTED LEAST SQUARE MEAN (ALSM) OF EAA WAS CALCULATED AND COMPARED BETWEEN SURVIVORS AND CONTROLS, ACROSS TREATMENT EXPOSURES AND HEALTH BEHAVIORS. ASSOCIATIONS OF EAA WITH 20 CLINICALLY ASSESSED CHCS WERE EVALUATED WITH MULTIVARIABLE PIECEWISE-EXPONENTIAL MODELS. ALL STATISTICAL TESTS FOR P VALUES BELOW WERE 2-SIDED. RESULTS: EAA WAS STATISTICALLY SIGNIFICANTLY HIGHER IN SURVIVORS THAN CONTROLS (ALSM = 0.63, 95% CONFIDENCE INTERVAL [CI] = 0.26 TO 1.01 VS -3.61, 95% CI = -4.43 TO 2.80). IN A MULTIVARIABLE MODEL AMONG SURVIVORS, STATISTICALLY SIGNIFICANTLY HIGHER EAA (P < .05) WAS OBSERVED IN THOSE EXPOSED TO CHEST RADIOTHERAPY, ABDOMEN OR PELVIC RADIOTHERAPY, ALKYLATING AGENTS, GLUCOCORTICOIDS, OR EPIPODOPHYLLOTOXINS. COMPARED WITH SURVIVORS WITH FAVORABLE HEALTH BEHAVIORS (ALSM = 0.26, 95% CI=-0.36 TO 0.87), EAA WAS STATISTICALLY SIGNIFICANTLY HIGHER AMONG SURVIVORS WITH INTERMEDIATE (ALSM = 1.07, 95% CI = 0.59 TO 1.54) OR UNFAVORABLE HEALTH BEHAVIORS (ALSM = 1.45, 95% CI = 0.60 TO 2.30). IN TIME-TO-EVENT ANALYSES, STATISTICALLY SIGNIFICANT ASSOCIATIONS WERE IDENTIFIED BETWEEN EAA TERTILES AND INCIDENCE OF 7 CHCS: HYPERTENSION (3RD VS 1ST TERTILE, RELATIVE RATE [RR] = 1.83, 95% CI = 1.17 TO 2.83), MYOCARDIAL INFARCTION (RR = 2.91, 95% CI = 1.27 TO 7.21), OBESITY (RR = 1.39, 95% CI = 1.17 TO 1.66), OBSTRUCTIVE PULMONARY DEFICIT (RR = 1.86, 95% CI = 0.95 TO 3.77), PERIPHERAL MOTOR NEUROPATHY (RR = 2.89, 95% CI = 1.24 TO 6.97), PERIPHERAL SENSORY NEUROPATHY (RR = 2.04, 95% CI = 0.99 TO 4.26), AND PULMONARY DIFFUSION DEFICITS (RR = 2.75, 95% CI = 0.95 TO 7.63). CONCLUSIONS: EAA IS STATISTICALLY SIGNIFICANTLY HIGHER IN SURVIVORS OF CHILDHOOD CANCER THAN IN NONCANCER CONTROLS AND IS ASSOCIATED WITH SPECIFIC TREATMENT EXPOSURES, UNFAVORABLE HEALTH BEHAVIORS, AND PRESENCE OF SPECIFIC CHCS.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
10  1959  52 EPIGENETIC AGING AND HEMATOPOIETIC CELL TRANSPLANTATION IN PATIENTS WITH SEVERE APLASTIC ANEMIA. CELLULAR AGING IN HEMATOPOIETIC CELL TRANSPLANTATION (HCT) IS IMPORTANT IN THE CONTEXT OF IMMUNE RECONSTITUTION AND AGE-RELATED COMPLICATIONS. RECENTLY, SEVERAL DNA-METHYLATION (DNAM)-BASED BIOMARKERS OF AGING KNOWN AS "EPIGENETIC CLOCKS" HAVE BEEN INTRODUCED AS NOVEL TOOLS TO PREDICT CELLULAR AGE. HERE, WE USED COX PROPORTIONAL HAZARDS MODELS TO ASSESS THE POSSIBLE ASSOCIATIONS OF DONOR PRE-HCT DNAM AGE, AND ITS POST-HCT CHANGES, USING THE RECENTLY PUBLISHED LIFESPAN-ASSOCIATED EPIGENETIC CLOCK KNOWN AS "DNAM-GRIMAGE," WITH OUTCOMES AMONG PATIENTS WITH SEVERE APLASTIC ANEMIA (SAA). THE STUDY INCLUDED 732 SAA PATIENTS FROM THE TRANSPLANT OUTCOMES IN APLASTIC ANEMIA PROJECT, WHO UNDERWENT UNRELATED DONOR HCT AND FOR WHOM A DONOR PRE-HCT BLOOD DNA SAMPLE WAS AVAILABLE; 41 ALSO HAD A POST-HCT SAMPLE COLLECTED AT DAY 100. IN MULTIVARIABLE ANALYSES, WE FOUND SIMILAR ASSOCIATIONS FOR DONOR CHRONOLOGICAL AGE AND PRE-HCT DNAM-GRIMAGE WITH POST-HCT SURVIVAL (HAZARD RATIO [HR] PER DECADE = 1.13; 95% CONFIDENCE INTERVAL [CI], 0.99-1.28; P = .07 AND HR = 1.14; 95% CI, 0.99-1.28; P = .06, RESPECTIVELY). IN DONORS WITH 10+ YEARS OF GRIMAGE ACCELERATION (IE, DEVIATION FROM EXPECTED DNAM AGE FOR CHRONOLOGICAL AGE), ELEVATED RISKS OF CHRONIC GRAFT VERSUS HOST DISEASE (HR = 2.4; 95% CI, 1.21-4.65; P = .01) AND POSSIBLY POST-HCT MORTALITY (HR = 1.79; 95% CI, 0.96-3.33; P = .07) WERE OBSERVED. IN THE SUBSET WITH POST-HCT SAMPLES, WE OBSERVED A SIGNIFICANT INCREASE IN DNAM-GRIMAGE IN THE FIRST 100 DAYS AFTER HCT (MEDIAN CHANGE 12.5 YEARS, RANGE 1.4 TO 26.4). HIGHER DNAM-GRIMAGE AFTER HCT WAS ASSOCIATED WITH INFERIOR SURVIVAL (HR PER YEAR = 1.11; 95% CI, 1.02-1.21; P = .01), PREDOMINANTLY WITHIN THE FIRST YEAR AFTER HCT. THIS STUDY HIGHLIGHTS THE POSSIBLE ROLE CELLULAR AGING MAY PLAY IN HCT OUTCOMES.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
11  6018  55 THE ASSOCIATION OF EPIGENETIC AGE ACCELERATION AND MULTIMORBIDITY AT AGE 90 IN THE WOMEN'S HEALTH INITIATIVE. BACKGROUND: EPIGENETIC AGE ACCELERATION (EAA), A MEASURE OF ACCELERATED BIOLOGICAL AGING, HAS BEEN ASSOCIATED WITH INCREASED RISK OF SEVERAL AGE-RELATED CHRONIC CONDITIONS. THIS IS THE FIRST STUDY TO PROSPECTIVELY EXAMINE THE RELATIONSHIP BETWEEN EAA AND BOTH MULTIMORBIDITY COUNT AND A WEIGHTED MULTIMORBIDITY SCORE AMONG LONG-LIVED POSTMENOPAUSAL WOMEN. METHODS: WE INCLUDED 1,951 WOMEN FROM THE WOMEN'S HEALTH INITIATIVE WHO COULD HAVE SURVIVED TO AGE 90. EAA WAS ESTIMATED USING THE HORVATH PAN-TISSUE, HANNUM, PHENOAGE AND GRIMAGE "CLOCKS." TWELVE CHRONIC CONDITIONS WERE INCLUDED IN THE MULTIMORBIDITY COUNT. THE MULTIMORBIDITY SCORE WAS WEIGHTED FOR EACH MORBIDITY'S RELATIONSHIP WITH MORTALITY IN THE STUDY POPULATION. USING MIXED-EFFECTS POISSON AND LINEAR REGRESSION MODELS THAT INCLUDED BASELINE COVARIATES ASSOCIATED WITH BOTH EAA AND MULTIMORBIDITY, WE ESTIMATED RELATIVE RISKS (RRS) AND 95% CONFIDENCE INTERVALS (CIS) FOR THE RELATIONSHIPS BETWEEN EACH EAA MEASURE AT STUDY BASELINE WITH BOTH MULTIMORBIDITY COUNT AND WEIGHTED MULTIMORBIDITY SCORE AT AGE 90, RESPECTIVELY. RESULTS: FOR EVERY ONE-STANDARD DEVIATION INCREASE IN AGEACCELPHENO, THE RATE OF MULTIMORBIDITY ACCUMULATION INCREASED 6% (RR=1.06; 95% CI=1.01-1.12; P=0.025) AND THE MULTIMORBIDITY SCORE BY 7% (RR=1.07; 95% CI=1.01-1.13; P=0.014) FOR WOMEN WHO SURVIVED TO AGE 90. THE RESULTS FOR A ONE-STANDARD DEVIATION INCREASE IN AGEACCELHORVATH, AGEACCELHANNUM AND AGEACCELGRIM WITH MULTIMORBIDITY ACCUMULATION AND SCORE WERE WEAKER COMPARED TO AGEACCELPHENO, AND THE LATTER TWO DID NOT REACH STATISTICAL SIGNIFICANCE. CONCLUSION: AGEACCELPHENO AND AGEACCELHANNUM MAY PREDICT MULTIMORBIDITY COUNT AND SCORE AT AGE 90 IN OLDER WOMEN AND, THUS, MAY BE USEFUL AS A BIOMARKER PREDICTOR OF MULTIMORBIDITY BURDEN IN THE LAST DECADES OF LIFE.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
12   648  35 BIRTH WEIGHT AND MATERNAL ENERGY STATUS DURING PREGNANCY AS PREDICTORS OF EPIGENETIC AGE ACCELERATION IN YOUNG ADULTS FROM METROPOLITAN CEBU, PHILIPPINES. EPIGENETIC CLOCKS QUANTIFY REGULAR CHANGES IN DNA METHYLATION THAT OCCUR WITH AGE, OR IN RELATION TO BIOMARKERS OF AGEING, AND ARE STRONG PREDICTORS OF MORBIDITY AND MORTALITY. HERE, WE ASSESS WHETHER MEASURES OF FETAL NUTRITION AND GROWTH THAT PREDICT ADULT CHRONIC DISEASE ALSO PREDICT ACCELERATED BIOLOGICAL AGEING IN YOUNG ADULTHOOD USING A SUITE OF COMMONLY USED EPIGENETIC CLOCKS. DATA COME FROM THE CEBU LONGITUDINAL HEALTH AND NUTRITION SURVEY (CLHNS), A LONG-RUNNING COHORT FOLLOWED SINCE BIRTH IN METROPOLITAN CEBU, PHILIPPINES. PAST WORK HAS SHOWN THAT BIRTH WEIGHT (BW) AND THE MOTHER'S ARM FAT DURING PREGNANCY (A MEASURE OF PREGNANCY ENERGY STATUS) RELATE INVERSELY TO HEALTH OUTCOMES IN THE CLHNS BUT PRIMARILY IN MALES. GENOME-WIDE DNA METHYLATION WAS ASSESSED IN WHOLE BLOOD USING THE INFINIUM EPIC ARRAY. PARTICIPANTS INCLUDED MALES (N=895) AND FEMALES (N=803) MEASURED IN 2005 (20.8-22.5 YEARS). CLOCKS INCLUDED THE HANNUM AND HORVATH CLOCKS TRAINED ON CHRONOLOGICAL AGE, THE DNAMPHENOAGE AND DNAMGRIMAGE CLOCKS TRAINED ON CLINICAL BIOMARKERS, THE DUNEDIN PACE OF AGEING (DUNEDINPACE) CLOCK TRAINED ON LONGITUDINAL CHANGES IN AGEING BIOMARKERS, AND THE DNAMTL CLOCK TRAINED ON LEUKOCYTE TELOMERE LENGTH. IN MALES, LOWER BW PREDICTED ADVANCED BIOLOGICAL AGEING USING THE HANNUM, DNAMPHENOAGE, DUNEDINPOAM, AND DNAMTL CLOCKS. IN CONTRAST, BW DID NOT PREDICT ANY CLOCK IN FEMALE PARTICIPANTS. PARTICIPANTS' MOTHERS' PREGNANCY ARM FAT ONLY PREDICTED DNAMTL IN MALES. THESE FINDINGS SUGGEST THAT EPIGENETIC CLOCKS ARE A USEFUL TOOL FOR GAUGING LONG-TERM OUTCOMES PREDICTED BY FETAL GROWTH, AND ADD TO EXISTING EVIDENCE IN THE CLHNS FOR SEX DIFFERENCES IN THESE RELATIONSHIPS.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
13  4502  47 MORTALITY ASSOCIATIONS WITH DNA METHYLATION-BASED BIOLOGICAL AGING AND PHYSICAL FUNCTIONING MEASURES ACROSS A 20-YEAR FOLLOW-UP PERIOD. BACKGROUND: MEASURES OF BIOLOGICAL AGING RANGE FROM DNA METHYLATION (DNAM)-BASED ESTIMATES TO MEASURES OF PHYSICAL ABILITIES. THE PURPOSE OF THIS STUDY WAS TO COMPARE DNAM- AND PHYSICAL FUNCTIONING-BASED MEASURES OF BIOLOGICAL AGING IN PREDICTING MORTALITY. METHODS: WE STUDIED 63- TO 76-YEAR-OLD WOMEN (N = 395) FROM THE FINNISH TWIN STUDY ON AGING (FITSA). PARTICIPANTS' BIOLOGICAL AGE (EPIGENETIC CLOCKS DNAM GRIMAGE AND DUNEDINPACE) WAS ESTIMATED USING BLOOD DNAM DATA. TESTS OF PHYSICAL FUNCTIONING CONDUCTED UNDER STANDARDIZED LABORATORY CONDITIONS INCLUDED THE TIMED UP AND GO (TUG) TEST AND 10-M WALK TEST. MORTALITY HAZARD RATIOS WERE CALCULATED PER EVERY 1 STANDARD DEVIATION (SD) INCREASE IN THE PREDICTOR. COX REGRESSION MODELS WERE CONDUCTED FOR INDIVIDUALS AND TWIN PAIRS, THE LATTER CONTROLLING FOR UNDERLYING GENETIC EFFECTS. THE MODELS WERE ADJUSTED FOR KNOWN LIFESTYLE PREDICTORS OF MORTALITY. RESULTS: DURING THE FOLLOW-UP PERIOD (MEAN 17.0 YEARS, RANGE 0.2-20.3), 187 PARTICIPANTS DIED. IN BOTH THE INDIVIDUAL-BASED AND PAIRWISE ANALYSES, GRIMAGE AND BOTH FUNCTIONAL BIOMARKERS OF AGING WERE ASSOCIATED WITH MORTALITY INDEPENDENT OF FAMILY RELATEDNESS, CHRONOLOGICAL AGE, PHYSICAL ACTIVITY, BODY MASS INDEX, SMOKING, EDUCATION, OR CHRONIC DISEASES. IN A MODEL INCLUDING BOTH THE DNAM-BASED MEASURES AND FUNCTIONAL BIOMARKERS OF AGING, GRIMAGE AND TUG REMAINED PREDICTIVE. CONCLUSIONS: THE FINDINGS SUGGEST THAT DNAM GRIMAGE AND THE TUG TEST ARE STRONG PREDICTORS OF MORTALITY INDEPENDENT OF EACH OTHERS AND GENETIC INFLUENCES. DNAM-BASED MEASURES AND FUNCTIONAL TESTS CAPTURE DIFFERENT ASPECTS OF THE AGING PROCESS AND THUS COMPLEMENT EACH OTHER AS MEASURES OF BIOLOGICAL AGING IN PREDICTING MORTALITY.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
14  3053  46 GENOME-WIDE ASSOCIATION STUDIES IDENTIFY NOVEL GENETIC LOCI FOR EPIGENETIC AGE ACCELERATION AMONG SURVIVORS OF CHILDHOOD CANCER. BACKGROUND: INCREASED EPIGENETIC AGE ACCELERATION (EAA) IN SURVIVORS OF CHILDHOOD CANCER IS ASSOCIATED WITH SPECIFIC TREATMENT EXPOSURES, UNFAVORABLE HEALTH BEHAVIORS, AND PRESENCE OF CERTAIN CHRONIC HEALTH CONDITIONS. TO BETTER UNDERSTAND INTER-INDIVIDUAL VARIABILITY, WE INVESTIGATED THE GENETIC BASIS UNDERLYING EAA. METHODS: GENOME-WIDE ASSOCIATION STUDIES OF EAA BASED ON MULTIPLE EPIGENETIC CLOCKS (HANNUM, HORVATH, PHENOAGE, AND GRIMAGE) WERE PERFORMED. METHYLATIONEPIC BEADCHIP ARRAY AND WHOLE-GENOME SEQUENCING DATA WERE GENERATED WITH BLOOD-DERIVED DNA FROM PARTICIPANTS IN THE ST. JUDE LIFETIME COHORT STUDY (DISCOVERY: 2138 PRE-EXISTING AND 502 NEWLY GENERATED DATA, ALL SURVIVORS; EXPLORATORY: 282 COMMUNITY CONTROLS). LINEAR REGRESSION MODELS WERE FIT FOR EACH EPIGENETIC AGE AGAINST THE ALLELIC DOSE OF EACH GENETIC VARIANT, ADJUSTING FOR AGE AT SAMPLING, SEX, AND CANCER TREATMENT EXPOSURES. FIXED-EFFECTS META-ANALYSIS WAS USED TO COMBINE SUMMARY STATISTICS FROM TWO DISCOVERY DATA SETS. LD (LINKAGE DISEQUILIBRIUM) SCORE REGRESSION WAS USED TO ESTIMATE SINGLE-NUCLEOTIDE POLYMORPHISM (SNP)-BASED HERITABILITY. RESULTS: FOR EAA-HORVATH, A GENOME-WIDE SIGNIFICANT ASSOCIATION WAS MAPPED TO THE SELP GENE WITH THE STRONGEST SNP RS732314 (META-GWAS: BETA=0.57, P=3.30X10(-11)). MOREOVER, THE STRATIFIED ANALYSIS OF THE ASSOCIATION BETWEEN RS732314 AND EAA-HORVATH SHOWED A SUBSTANTIAL HETEROGENEITY BETWEEN CHILDREN AND ADULTS (META-GWAS: BETA=0.97 VS. 0.51, I(2)=73.1%) AS WELL AS BETWEEN SURVIVORS WITH AND WITHOUT CHEST/ABDOMINAL/PELVIC-RT EXPOSURE (BETA=0.64 VS. 0.31, I(2)=66.3%). FOR EAA-HANNUM, AN ASSOCIATION WAS MAPPED TO THE HLA LOCUS WITH THE STRONGEST SNP RS28366133 (META-GWAS: BETA=0.78, P=3.78X10(-11)). THERE WAS NO GENOME-WIDE SIGNIFICANT HIT FOR EAA-PHENOAGE OR EAA-GRIMAGE. INTERESTINGLY, AMONG COMMUNITY CONTROLS, RS732314 WAS ASSOCIATED WITH EAA-HORVATH (BETA=1.09, P=5.43X10(-5)), WHEREAS RS28366133 WAS NOT ASSOCIATED WITH EAA-HANNUM (BETA=0.21, P=0.49). THE ESTIMATED HERITABILITY WAS 0.33 (SE=0.20) FOR EAA-HORVATH AND 0.17 (SE=0.23) FOR EAA-HANNUM, BUT CLOSE TO ZERO FOR EAA-PHENOAGE AND EAA-GRIMAGE. CONCLUSIONS: WE IDENTIFIED NOVEL GENETIC VARIANTS IN THE SELP GENE AND HLA REGION ASSOCIATED WITH EAA-HORVATH AND EAA-HANNUM, RESPECTIVELY, AMONG SURVIVORS OF CHILDHOOD CANCER. THE NEW GENETIC VARIANTS IN COMBINATION WITH OTHER REPLICATED KNOWN VARIANTS CAN FACILITATE THE IDENTIFICATION OF SURVIVORS AT HIGHER RISK IN DEVELOPING ACCELERATED AGING AND POTENTIALLY INFORM DRUG TARGETS FOR FUTURE INTERVENTION STRATEGIES AMONG VULNERABLE SURVIVORS.	2022	
                                                                                                                                                                                                                                                                                                                                                                        
15  1956  51 EPIGENETIC AGE IN PERIPHERAL BLOOD AMONG CHILDREN, ADOLESCENT, AND ADULT SURVIVORS OF CHILDHOOD CANCER. IMPORTANCE: CERTAIN CANCER THERAPIES ARE RISK FACTORS FOR EPIGENETIC AGE ACCELERATION (EAA) AMONG SURVIVORS OF CHILDHOOD CANCER, AND EAA IS ASSOCIATED WITH CHRONIC HEALTH CONDITIONS (CHCS). HOWEVER, SMALL NUMBERS OF YOUNGER SURVIVORS (AGED <20 YEARS) PREVIOUSLY EVALUATED HAVE LIMITED THE ABILITY TO CALCULATE EAA AMONG THIS AGE GROUP. OBJECTIVE: TO EVALUATE THE CHANGE RATE OF EPIGENETIC AGE (EA) AND EAA IN YOUNGER COMPARED WITH OLDER SURVIVORS AND THE POSSIBLE ASSOCIATION OF EAA WITH EARLY-ONSET OBESITY (AGED <20 YEARS), SEVERITY/BURDEN OF CHCS, AND LATE MORTALITY (>5 YEARS FROM CANCER DIAGNOSIS). DESIGN, SETTING, AND PARTICIPANTS: STUDY PARTICIPANTS WERE FROM THE ST JUDE LIFETIME COHORT, INITIATED IN 2007 WITH ONGOING FOLLOW-UP. THE PRESENT STUDY WAS CONDUCTED FROM APRIL 17, 2022, TO MARCH 23, 2023. SURVIVORS IN THIS COHORT OF EUROPEAN ANCESTRY WITH DNA METHYLATION DATA WERE INCLUDED. CROSS-SECTIONAL ANNUAL CHANGES IN EA AND EAA WERE COMPARED ACROSS 5 DIFFERENT CHRONOLOGIC AGE GROUPS: AGE 0 TO 9 (CHILDREN), 10 TO 19 (ADOLESCENTS), 20 TO 34 (YOUNGER ADULTS), 35 TO 49 (MIDDLE-AGED ADULTS), AND GREATER THAN OR EQUAL TO 50 (OLDER ADULTS) YEARS. LOGISTIC REGRESSION EVALUATED THE ASSOCIATION BETWEEN EAA AND EARLY-ONSET OBESITY OR SEVERITY/BURDEN OF CHCS. COX PROPORTIONAL HAZARDS REGRESSION ASSESSED THE ASSOCIATION BETWEEN EAA AND LATE MORTALITY. MAIN OUTCOMES AND MEASURES: EARLY-ONSET OBESITY, SEVERITY/BURDEN OF CHCS (GRADED USING THE COMMON TERMINOLOGY CRITERIA FOR ADVERSE EVENTS (GRADE 1, MILD; 2, MODERATE; 3, SEVERE/DISABLING; 4, LIFE-THREATENING) AND WERE COMBINED INTO HIGH VS LOW SEVERITY/BURDEN BASED ON FREQUENCY AND GRADE), AND LATE MORTALITY WERE THE OUTCOMES BASED ON FOLLOW-UP UNTIL APRIL 2020. EXPANDED DNA METHYLATION PROFILING INCREASED THE NUMBER OF SURVIVORS YOUNGER THAN 20 YEARS (N = 690). EPIGENETIC AGE WAS CALCULATED PRIMARILY USING THE LEVINE CLOCK, AND EAA WAS DERIVED FROM LEAST SQUARES REGRESSION OF EA AGAINST CHRONOLOGIC AGE AND WAS STANDARDIZED TO A Z SCORE (LEVINE EEA). RESULTS: AMONG 2846 PARTICIPANTS (MEDIAN AGE, 30.3 [IQR, 9.3-41.5] YEARS; 53% MALES), THE CROSS-SECTIONAL ANNUAL CHANGE IN EA_LEVINE WAS HIGHER IN CHILDREN (1.63 YEARS) AND ADOLESCENTS (1.14 YEARS), AND THE ADJUSTED LEAST-SQUARES MEAN OF LEVINE EEA WAS LOWER IN CHILDREN (-0.22 YEARS) AND OLDER ADULTS (-1.70 YEARS). EACH 1-SD INCREASE IN LEVINE EEA WAS ASSOCIATED WITH INCREASED RISK OF DEVELOPING EARLY-ONSET OBESITY (ODDS RATIO [OR], 1.46; 95% CI, 1.19-1.78), HIGH SEVERITY/BURDEN OF CHCS (OR, 1.13; 95% CI, 1.03-1.24), AND LATE MORTALITY (HAZARD RATIO, 1.75; 95% CI, 1.35-2.26). CONCLUSIONS AND RELEVANCE: THE FINDINGS OF THIS STUDY SUGGEST THAT EAA MEASURED IN CHILDREN AND ADOLESCENT SURVIVORS OF CHILDHOOD CANCER IS ASSOCIATED WITH EARLY-ONSET OBESITY, SEVERITY/BURDEN OF ALL CHCS, AND LATE MORTALITY. EVALUATING EAA MAY HELP IDENTIFY SURVIVORS OF CHILDHOOD CANCER AT INCREASED RISK FOR EARLY-ONSET OBESITY, MORBIDITY IN GENERAL, AND MORTALITY.	2023	

16  2044  42 EPIGENETIC CLOCK ANALYSIS OF BLOOD SAMPLES IN DRUG-NAIVE FIRST-EPISODE SCHIZOPHRENIA PATIENTS. BACKGROUND: SCHIZOPHRENIA (SCZ) IS A SEVERE AND CHRONIC PSYCHIATRIC DISORDER WITH PREMATURE AGE-RELATED PHYSIOLOGICAL CHANGES. HOWEVER, NUMEROUS PREVIOUS STUDIES EXAMINED THE EPIGENETIC AGE ACCELERATION IN SCZ PATIENTS AND YIELDED INCONCLUSIVE RESULTS. IN THIS STUDY, WE PROPOSE TO EXPLORE THE EPIGENETIC AGE ACCELERATION IN DRUG-NAIVE FIRST-EPISODE SCZ (FSCZ) PATIENTS AND INVESTIGATE WHETHER EPIGENETIC AGE ACCELERATION IS ASSOCIATED WITH ANTIPSYCHOTIC TREATMENT, PSYCHOTIC SYMPTOMS, COGNITION, AND SUBCORTICAL VOLUMES. METHODS: WE ASSESSED THE EPIGENETIC AGE IN 38 DRUG-NAIVE FSCZ PATIENTS AND 38 HEALTHY CONTROLS BY USING THREE INDEPENDENT CLOCKS, INCLUDING HORVATH, HANNUM AND LEVINE ALGORITHMS. THE EPIGENETIC AGE MEASUREMENTS IN SCZ PATIENTS WERE REPEATED AFTER RECEIVING 8 WEEKS RISPERIDONE MONOTHERAPY. RESULTS: OUR FINDINGS SHOWED SIGNIFICANTLY POSITIVE CORRELATIONS BETWEEN EPIGENETIC AGES ASSESSED BY THREE CLOCKS AND CHRONOLOGICAL AGE IN BOTH FSCZ PATIENTS AND HEALTHY CONTROLS. COMPARED WITH HEALTHY CONTROLS, DRUG-NAIVE FSCZ PATIENTS HAVE A SIGNIFICANT EPIGENETIC AGE DECELERATION IN HORVATH CLOCK (P = 0.01), BUT NOT IN HANNUM CLOCK (P = 0.07) AND LEVINE CLOCK (P = 0.43). THE EPIGENETIC AGES OF HANNUM CLOCK (P = 0.002) AND LEVINE CLOCK (P = 0.01) WERE SIGNIFICANTLY ACCELERATED IN SCZ PATIENTS AFTER 8-WEEK RISPERIDONE TREATMENT. HOWEVER, NO SIGNIFICANT ASSOCIATIONS BETWEEN EPIGENETIC AGE ACCELERATION AND PSYCHOTIC SYMPTOMS, COGNITIVE FUNCTION, AS WELL AS SUBCORTICAL VOLUMES WERE OBSERVED IN FSCZ PATIENTS. CONCLUSION: THESE RESULTS DEMONSTRATE THAT DISTINCT EPIGENETIC CLOCKS ARE SENSITIVE TO DIFFERENT ASPECTS OF AGING PROCESS. FURTHER INVESTIGATIONS WITH COMPREHENSIVE EPIGENETIC CLOCK ANALYSES AND LARGE SAMPLES ARE REQUIRED TO CONFIRM OUR FINDINGS.	2023	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
17  3879  30 KERATIN 19-EXPRESSING HEPATOCELLULAR CARCINOMA AND SMALL-DUCT TYPE INTRAHEPATIC CHOLANGIOCARCINOMA SHOW A SIMILAR POSTOPERATIVE CLINICAL COURSE BUT HAVE DISTINCT GENETIC FEATURES. AIMS: THE PRESENT STUDY AIMED TO SYSTEMATICALLY COMPARE CLINICOPATHOLOGICAL AND GENETIC FEATURES BETWEEN KERATIN 19 (K19)-EXPRESSING HEPATOCELLULAR CARCINOMA (HCC) AND INTRAHEPATIC CHOLANGIOCARCINOMA (ICCA). METHODS AND RESULTS: CONSECUTIVE CASES OF HCC (N = 430) WERE CLASSIFIED INTO K19(+) AND K19(-) USING IMMUNOHISTOCHEMISTRY. ICCA CASES WERE ALSO SEPARATED INTO SMALL-(S-ICCA; N = 36) AND LARGE-DUCT TYPES (N = 22) BASED ON RECENTLY PROPOSED CRITERIA, WITH THE FORMER BEING USED IN THE PRESENT STUDY. MUTATIONAL HOT-SPOTS IN TERT, CTNNB1, KRAS AND IDH1 WERE SEQUENCED. TWENTY-SIX CASES (6%) OF HCC EXPRESSED K19. K19(+) HCC WAS MORE STRONGLY ASSOCIATED WITH CHRONIC HEPATITIS B THAN K19(-) HCC AND S-ICCA (46% VERSUS 17% AND 6%; BOTH P < 0.001). LYMPH NODE METASTASIS WAS OBSERVED IN K19(+) HCC (8%) AND S-ICCA (22%), BUT WAS EXCEPTIONAL IN K19(-) HCC (1%). K19(+) HCC HAD TERT PROMOTER MUTATIONS LESS FREQUENTLY THAN K19(-) HCC (31% VERSUS 59%; P = 0.022), AND LACKED ALTERATIONS IN KRAS AND IDH1. CTNNB1 MUTATIONS WERE SIMILARLY OBSERVED IN K19(+) AND K19(-) HCC (23% AND 19%, RESPECTIVELY), BUT RARE IN S-ICCA (3%). THE POSTOPERATIVE SURVIVAL CURVE OF K19(+) HCC WAS ALMOST IDENTICAL TO THAT OF S-ICCA IN THE FIRST 5 YEARS (APPROXIMATELY 50% AT 5 YEARS), AND SIGNIFICANTLY WORSE THAN THAT OF K19(-) HCC (P = 0.040). EXTRAHEPATIC RECURRENCE WAS MORE COMMON IN K19(+) HCC (50%) AND S-ICCA (35%) THAN IN K19(-) HCC (15%) (P = 0.001). CONCLUSIONS: ALTHOUGH K19(+) HCC AND S-ICCA SHOWED SIMILAR BIOLOGICAL BEHAVIOURS, THEY DID NOT SHARE ANY DRIVER GENE MUTATIONS, SUGGESTING THE POSSIBLE INVOLVEMENT OF EPIGENETIC ALTERATIONS IN THE ICCA-LIKE FEATURES OF K19(+) HCC.	2019	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
18  6017  56 THE ASSOCIATION OF ACCELERATED EPIGENETIC AGE WITH ALL-CAUSE MORTALITY IN CARDIAC CATHETERIZATION PATIENTS AS MEDIATED BY VASCULAR AND CARDIOMETABOLIC OUTCOMES. BACKGROUND: EPIGENETIC AGE IS A DNA METHYLATION-BASED BIOMARKER OF AGING THAT IS ACCURATE ACROSS THE LIFESPAN AND A RANGE OF CELL TYPES. THE DIFFERENCE BETWEEN EPIGENETIC AGE AND CHRONOLOGICAL AGE, TERMED AGE ACCELERATION (AA), IS A STRONG PREDICTOR OF LIFESPAN AND HEALTHSPAN. THE PREDICTIVE CAPABILITIES OF AA FOR ALL-CAUSE MORTALITY HAVE BEEN EVALUATED IN THE GENERAL POPULATION; HOWEVER, ITS UTILITY IS LESS WELL EVALUATED IN THOSE WITH CHRONIC CONDITIONS. ADDITIONALLY, THE PATHOPHYSIOLOGIC PATHWAYS WHEREBY AA PREDICTS MORTALITY ARE UNCLEAR. WE HYPOTHESIZED THAT AA PREDICTS MORTALITY IN INDIVIDUALS WITH UNDERLYING CARDIOVASCULAR DISEASE; AND THE ASSOCIATION BETWEEN AA AND MORTALITY IS MEDIATED, IN PART, BY VASCULAR AND CARDIOMETABOLIC MEASURES. METHODS: WE EVALUATED 562 PARTICIPANTS IN AN URBAN, THREE-COUNTY AREA OF CENTRAL NORTH CAROLINA FROM THE CATHGEN COHORT, ALL OF WHOM RECEIVED A CARDIAC CATHETERIZATION PROCEDURE. WE ANALYZED THREE AA BIOMARKERS, HORVATH EPIGENETIC AGE ACCELERATION (HAA), PHENOTYPIC AGE ACCELERATION (PHENOAA), AND GRIM AGE ACCELERATION (GRIMAA), BY COX REGRESSION MODELS, TO ASSESS WHETHER AAS WERE ASSOCIATED WITH ALL-CAUSE MORTALITY. WE ALSO EVALUATED IF THESE ASSOCIATIONS WERE MEDIATED BY VASCULAR AND CARDIOMETABOLIC OUTCOMES, INCLUDING LEFT VENTRICULAR EJECTION FRACTION (LVEF), BLOOD CHOLESTEROL CONCENTRATIONS, ANGIOPOIETIN-2 (ANG2) PROTEIN CONCENTRATION, PERIPHERAL ARTERY DISEASE, CORONARY ARTERY DISEASE, DIABETES, AND HYPERTENSION. THE TOTAL EFFECT, DIRECT EFFECT, INDIRECT EFFECT, AND PERCENTAGE MEDIATED WERE ESTIMATED USING PATHWAY MEDIATION TESTS WITH A REGRESSION ADJUSTMENT APPROACH. RESULTS: PHENOAA (HR = 1.05, P < 0.0001), GRIMAA (HR = 1.10, P < 0.0001) AND HAA (HR = 1.03, P = 0.01) WERE ALL ASSOCIATED WITH ALL-CAUSE MORTALITY. THE ASSOCIATION OF MORTALITY AND PHENOAA WAS PARTIALLY MEDIATED BY ANG2, A MARKER OF VASCULAR FUNCTION (19.8%, P = 0.016), AND BY DIABETES (8.2%, P = 0.043). THE GRIMAA-MORTALITY ASSOCIATION WAS MEDIATED BY ANG2 (12.3%, P = 0.014), AND SHOWED WEAKER EVIDENCE FOR MEDIATION BY LVEF (5.3%, P = 0.065). CONCLUSIONS: EPIGENETIC AGE ACCELERATION REMAINS STRONGLY PREDICTIVE OF MORTALITY EVEN IN INDIVIDUALS ALREADY BURDENED WITH CARDIOVASCULAR DISEASE. MORTALITY ASSOCIATIONS WERE MEDIATED BY ANG2, WHICH REGULATES ENDOTHELIAL PERMEABILITY AND ANGIOGENIC FUNCTIONS, SUGGESTING THAT SPECIFIC VASCULAR PATHOPHYSIOLOGY MAY LINK ACCELERATED EPIGENETIC AGING WITH INCREASED MORTALITY RISKS.	2022	
                                                                                                                                                                                                                                                                                                                                                                                                                                                             
19  1351  36 DETERMINATION OF SALIVA EPIGENETIC AGE IN INFANCY, AND ITS ASSOCIATION WITH PARENTAL SOCIO-ECONOMIC CHARACTERISTICS AND PREGNANCY OUTCOMES. EPIGENETIC AGE ACCELERATION (AA) HAS BEEN ASSOCIATED WITH ADVERSE ENVIRONMENTAL EXPOSURES AND MANY CHRONIC CONDITIONS. WE ESTIMATED, IN THE NINFEA BIRTH COHORT, INFANT SALIVA EPIGENETIC AGE, AND INVESTIGATED WHETHER PARENTAL SOCIO-ECONOMIC POSITION (SEP) AND PREGNANCY OUTCOMES ARE ASSOCIATED WITH INFANT EPIGENETIC AA. A TOTAL OF 139 SALIVA SAMPLES COLLECTED AT ON AVERAGE 10.8 (RANGE 7-17) MONTHS WERE USED TO ESTIMATE HORVATH'S DNA METHYLATION AGE. EPIGENETIC AA WAS DEFINED AS THE RESIDUAL FROM A LINEAR REGRESSION OF EPIGENETIC AGE ON CHRONOLOGICAL AGE. LINEAR REGRESSION MODELS WERE USED TO TEST THE ASSOCIATIONS OF PARENTAL SEP AND PREGNANCY OUTCOMES WITH SALIVA EPIGENETIC AA. A MODERATE POSITIVE ASSOCIATION WAS FOUND BETWEEN DNA METHYLATION AGE AND CHRONOLOGICAL AGE, WITH THE MEDIAN ABSOLUTE DIFFERENCE OF 6.8 MONTHS (STANDARD DEVIATION [SD] 3.9). THE EVIDENCE OF THE ASSOCIATION BETWEEN THE INDICATORS OF LOW SEP AND EPIGENETIC AA WAS WEAK; INFANTS BORN TO UNEMPLOYED MOTHERS OR WITH LOW EDUCATION HAD ON AVERAGE 1 MONTH HIGHER EPIGENETIC AGE THAN INFANTS OF MOTHERS WITH HIGH EDUCATION AND EMPLOYMENT (COEFFICIENT 0.78 MONTHS, 95% CONFIDENCE INTERVALS [CIS]: -0.79 TO 2.34 FOR LOW/MEDIUM EDUCATION; 0.96, 95% CI: -1.81 TO 3.73 FOR UNEMPLOYMENT). THERE WAS NO EVIDENCE FOR ASSOCIATION OF GESTATIONAL AGE, BIRTHWEIGHT OR CAESAREAN SECTION WITH INFANT EPIGENETIC AA. USING THE HORVATH'S METHOD, DNA METHYLATION AGE CAN BE FAIRLY ACCURATELY PREDICTED FROM SALIVA SAMPLES ALREADY IN THE FIRST MONTHS OF LIFE. THIS STUDY DID NOT REVEAL CLEAR ASSOCIATIONS BETWEEN EITHER PREGNANCY OUTCOMES OR PARENTAL SOCIO-ECONOMIC CHARACTERISTICS AND INFANT SALIVA EPIGENETIC AA.	2021	
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
20  1963  39 EPIGENETIC AGING MEDIATES THE ASSOCIATION BETWEEN PAIN IMPACT AND BRAIN AGING IN MIDDLE TO OLDER AGE INDIVIDUALS WITH KNEE PAIN. CHRONIC MUSCULOSKELETAL PAIN IS A HEALTH BURDEN THAT MAY ACCELERATE THE AGING PROCESS. ACCELERATED BRAIN AGING AND EPIGENETIC AGING HAVE SEPARATELY BEEN OBSERVED IN THOSE WITH CHRONIC PAIN. HOWEVER, IT IS UNKNOWN WHETHER THESE BIOLOGICAL MARKERS OF AGING ARE ASSOCIATED WITH EACH OTHER IN THOSE WITH CHRONIC PAIN. WE AIMED TO EXPLORE THE ASSOCIATION OF EPIGENETIC AGING AND BRAIN AGING IN MIDDLE-TO-OLDER AGE INDIVIDUALS WITH VARYING DEGREES OF KNEE PAIN. PARTICIPANTS (57.91 +/- 8.04 Y) WITH LOW IMPACT KNEE PAIN (N = 95), HIGH IMPACT KNEE PAIN (N = 53), AND PAIN-FREE CONTROLS (N = 26) COMPLETED SELF-REPORTED PAIN, A BLOOD DRAW, AND AN MRI SCAN. WE USED AN EPIGENETIC CLOCK PREVIOUSLY ASSOCIATED WITH KNEE PAIN (DNAMGRIMAGE), THE SUBSEQUENT DIFFERENCE OF PREDICTED EPIGENETIC AND BRAIN AGE FROM CHRONOLOGICAL AGE (DNAMGRIMAGE-DIFFERENCE AND BRAIN-PAD, RESPECTIVELY). THERE WAS A SIGNIFICANT MAIN EFFECT FOR PAIN IMPACT GROUP (F (2,167) = 3.847, P = 0.023, ROTATIONAL ENERGY = 1 / 2IOMEGA2 = 0.038, ANCOVA) ON BRAIN-PAD AND DNAMGRIMAGE-DIFFERENCE (F (2,167) = 6.800, P = 0.001, I = MK2 = 0.075, ANCOVA) AFTER CONTROLLING FOR COVARIATES. DNAMGRIMAGE-DIFFERENCE AND BRAIN-PAD WERE MODESTLY CORRELATED (R =0.198; P =0.010). EXPLORATORY ANALYSIS REVEALED THAT DNAMGRIMAGE-DIFFERENCE MEDIATED GCPS PAIN IMPACT, GCPS PAIN SEVERITY, AND PAIN-RELATED DISABILITY SCORES ON BRAIN-PAD. BASED UPON THE CURRENT STUDY FINDINGS, WE SUGGEST THAT PAIN COULD BE A DRIVER FOR ACCELERATED BRAIN AGING VIA EPIGENOME INTERACTIONS.	2022