Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studies

Background: Life’s Essential 8 (LE8) is known to have a negative correlation with biological aging, while the relationship between the Life’s Crucial 9 (LC9) score, which includes mental health, and biological aging remains to be further investigated. Methods: We obtained data from two national coho...

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Main Authors: Haoran Wang, Jingwen Zhang, Jiaxin Ning, Yating Cui, Huimin Hou, Ming Liu, Jianyong Liu, Runhua Tang, Jianye Wang
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:The Journal of Nutrition, Health and Aging
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Online Access:http://www.sciencedirect.com/science/article/pii/S1279770725000995
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author Haoran Wang
Jingwen Zhang
Jiaxin Ning
Yating Cui
Huimin Hou
Ming Liu
Jianyong Liu
Runhua Tang
Jianye Wang
author_facet Haoran Wang
Jingwen Zhang
Jiaxin Ning
Yating Cui
Huimin Hou
Ming Liu
Jianyong Liu
Runhua Tang
Jianye Wang
author_sort Haoran Wang
collection DOAJ
description Background: Life’s Essential 8 (LE8) is known to have a negative correlation with biological aging, while the relationship between the Life’s Crucial 9 (LC9) score, which includes mental health, and biological aging remains to be further investigated. Methods: We obtained data from two national cohorts, the UK Biobank and National Health and Nutrition Examination Survey (NHANES), to analyze the association between LC9 and biological aging. Biological aging was assessed using PhenoAge and KDMAge, with gender, race, and other indicators included as covariates. We applied linear regression models and restricted cubic splines (RCS) to analyze and describe the relationship. Furthermore, we explored the mediating role of oxidative stress and inflammation in the association between LC9 and biological aging. Subgroup analyses were conducted using multiple linear regression models, and differences between subgroups were assessed through interaction p-value tests. Sensitivity analyses were subsequently performed, followed by an exploration of the underlying mechanisms. Results: In this study, the UK Biobank cohort included 46,599 participants, with 44,973 participants having complete data for all covariates, LC9, and the necessary calculations for PhenoAge and KDMage. In the NHANES cohort, these numbers were 11,726 and 5,936, respectively. In the UK Biobank cohort, a significant association was found between the LC9 score and PhenoAge (β = −2.484, p < 0.001), with similar results observed for KDMage (β = −7.987, p < 0.001). Similar findings were observed in the NHANES cohort, with significant associations between the LC9 score and both PhenoAge (β = −5.327, p < 0.001) and KDMAge (β = 11.826, p < 0.001). These findings align with previous research suggesting that higher LC9 scores are associated with slower biological aging. After multivariable adjustment, an ''inverse L-shaped'' relationship was observed (non-linear P < 0.001). In the mediation analysis, oxidative stress and inflammation showed significant mediating effects between LC9 and both PhenoAge and KDMage (p < 0.001 for both). In the subgroup analysis, the LC9 score showed broad applicability, particularly among male participants aged over 60 years. Conclusion: This cohort study suggests that higher LC9 scores are associated with slower biological aging. In addition to emphasizing diet and lifestyle habits, the role of mental health in biological aging should not be overlooked.
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spelling doaj-art-23d9befe106d48e4a7b353f125552c752025-08-20T03:17:08ZengElsevierThe Journal of Nutrition, Health and Aging1760-47882025-07-0129710057510.1016/j.jnha.2025.100575Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studiesHaoran Wang0Jingwen Zhang1Jiaxin Ning2Yating Cui3Huimin Hou4Ming Liu5Jianyong Liu6Runhua Tang7Jianye Wang8Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Beijing, ChinaDepartment of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, ChinaBeijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Beijing, ChinaDepartment of Critical Care Medicine, The First Medical Centre, Chinese PLA General Hospital, Beijing, 100853, China; Medical School of Chinese PLA, Beijing, 100853 ChinaBeijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Beijing, China; Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Fifth School of Clinical Medicine, Peking University, Beijing, ChinaBeijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Beijing, China; Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Fifth School of Clinical Medicine, Peking University, Beijing, ChinaDepartment of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China; Corresponding authors.Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Beijing, China; Corresponding authors.Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences &amp; Peking Union Medical College, Beijing, China; Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Corresponding authors.Background: Life’s Essential 8 (LE8) is known to have a negative correlation with biological aging, while the relationship between the Life’s Crucial 9 (LC9) score, which includes mental health, and biological aging remains to be further investigated. Methods: We obtained data from two national cohorts, the UK Biobank and National Health and Nutrition Examination Survey (NHANES), to analyze the association between LC9 and biological aging. Biological aging was assessed using PhenoAge and KDMAge, with gender, race, and other indicators included as covariates. We applied linear regression models and restricted cubic splines (RCS) to analyze and describe the relationship. Furthermore, we explored the mediating role of oxidative stress and inflammation in the association between LC9 and biological aging. Subgroup analyses were conducted using multiple linear regression models, and differences between subgroups were assessed through interaction p-value tests. Sensitivity analyses were subsequently performed, followed by an exploration of the underlying mechanisms. Results: In this study, the UK Biobank cohort included 46,599 participants, with 44,973 participants having complete data for all covariates, LC9, and the necessary calculations for PhenoAge and KDMage. In the NHANES cohort, these numbers were 11,726 and 5,936, respectively. In the UK Biobank cohort, a significant association was found between the LC9 score and PhenoAge (β = −2.484, p < 0.001), with similar results observed for KDMage (β = −7.987, p < 0.001). Similar findings were observed in the NHANES cohort, with significant associations between the LC9 score and both PhenoAge (β = −5.327, p < 0.001) and KDMAge (β = 11.826, p < 0.001). These findings align with previous research suggesting that higher LC9 scores are associated with slower biological aging. After multivariable adjustment, an ''inverse L-shaped'' relationship was observed (non-linear P < 0.001). In the mediation analysis, oxidative stress and inflammation showed significant mediating effects between LC9 and both PhenoAge and KDMage (p < 0.001 for both). In the subgroup analysis, the LC9 score showed broad applicability, particularly among male participants aged over 60 years. Conclusion: This cohort study suggests that higher LC9 scores are associated with slower biological aging. In addition to emphasizing diet and lifestyle habits, the role of mental health in biological aging should not be overlooked.http://www.sciencedirect.com/science/article/pii/S1279770725000995Life’s crucial 9UK biobankNAHNESBiological agingMediation analysis
spellingShingle Haoran Wang
Jingwen Zhang
Jiaxin Ning
Yating Cui
Huimin Hou
Ming Liu
Jianyong Liu
Runhua Tang
Jianye Wang
Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studies
The Journal of Nutrition, Health and Aging
Life’s crucial 9
UK biobank
NAHNES
Biological aging
Mediation analysis
title Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studies
title_full Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studies
title_fullStr Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studies
title_full_unstemmed Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studies
title_short Oxidative stress and inflammation mediate the association between Life's Crucial 9 and biological ageing: A secondary analysis of two observational studies
title_sort oxidative stress and inflammation mediate the association between life s crucial 9 and biological ageing a secondary analysis of two observational studies
topic Life’s crucial 9
UK biobank
NAHNES
Biological aging
Mediation analysis
url http://www.sciencedirect.com/science/article/pii/S1279770725000995
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