Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES program

Abstract Background Diabetes ranks as the ninth leading cause of death globally, and DNA-methylation age acceleration (DNAmAA) is closely linked to lifespan. However, the impact of DNAmAA on long-term outcomes in specific populations with diabetes and pre-diabetes has not yet been comprehensively st...

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Main Authors: Shuang Wu, Ziyi Zhong, Yimeng Wang, Jingyang Wang, Siqi Lyu, Hongyu Liu, Yang Chen
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Clinical Epigenetics
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Online Access:https://doi.org/10.1186/s13148-025-01886-0
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author Shuang Wu
Ziyi Zhong
Yimeng Wang
Jingyang Wang
Siqi Lyu
Hongyu Liu
Yang Chen
author_facet Shuang Wu
Ziyi Zhong
Yimeng Wang
Jingyang Wang
Siqi Lyu
Hongyu Liu
Yang Chen
author_sort Shuang Wu
collection DOAJ
description Abstract Background Diabetes ranks as the ninth leading cause of death globally, and DNA-methylation age acceleration (DNAmAA) is closely linked to lifespan. However, the impact of DNAmAA on long-term outcomes in specific populations with diabetes and pre-diabetes has not yet been comprehensively studied. Methods This retrospective cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, including participants aged 20 years or older diagnosed with diabetes or pre-diabetes. DNAmAA was defined as the difference between epigenetic age and chronological age. Multiple generations of DNAmAA measures were included. Cox proportional hazards regression models were employed to estimate the associations between DNAmAAs and all-cause, cardiovascular, and non-cardiovascular mortality. Results A total of 1,199 participants were included, with a mean age of 64.20 (0.46) years; 621 (51.8%) were male. Significant correlations were observed between chronological age and all DNA-methylation ages in both diabetes and pre-diabetes groups. Over a mean follow-up of 14.13 (5.90) years, 662 deaths were recorded. AgeAccelGrim2 exhibited the strongest association with mortality. Each 5-unit increase in AgeAccelGrim2 was associated with an elevated risk of all-cause mortality (HR 1.35, 95% CI 1.23–1.49), cardiovascular mortality (HR 1.50, 95% CI 1.25–1.80), and non-cardiovascular mortality (HR 1.30, 95% CI 1.16–1.46). These associations remained significant in participants with diabetes and pre-diabetes. Mediation analysis revealed that AgeAccelGrim2 significantly mediates the association between health-related exposures (including the Oxidative Balance Score, Life’s Simple 7 score, and frailty score) and all-cause mortality in diabetes and pre-diabetes populations. Conclusions AgeAccelGrim2 could serve as a valuable biomarker for mortality risk specific to populations with diabetes and pre-diabetes, offering potential applications in personalized management strategies and risk stratification.
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spelling doaj-art-401e2d87ad204abdbec5a3c460e1a38f2025-08-20T03:53:58ZengBMCClinical Epigenetics1868-70832025-05-0117111310.1186/s13148-025-01886-0Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES programShuang Wu0Ziyi Zhong1Yimeng Wang2Jingyang Wang3Siqi Lyu4Hongyu Liu5Yang Chen6National Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest HospitalNational Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeNational Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeNational Center for Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest HospitalLiverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest HospitalAbstract Background Diabetes ranks as the ninth leading cause of death globally, and DNA-methylation age acceleration (DNAmAA) is closely linked to lifespan. However, the impact of DNAmAA on long-term outcomes in specific populations with diabetes and pre-diabetes has not yet been comprehensively studied. Methods This retrospective cohort study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, including participants aged 20 years or older diagnosed with diabetes or pre-diabetes. DNAmAA was defined as the difference between epigenetic age and chronological age. Multiple generations of DNAmAA measures were included. Cox proportional hazards regression models were employed to estimate the associations between DNAmAAs and all-cause, cardiovascular, and non-cardiovascular mortality. Results A total of 1,199 participants were included, with a mean age of 64.20 (0.46) years; 621 (51.8%) were male. Significant correlations were observed between chronological age and all DNA-methylation ages in both diabetes and pre-diabetes groups. Over a mean follow-up of 14.13 (5.90) years, 662 deaths were recorded. AgeAccelGrim2 exhibited the strongest association with mortality. Each 5-unit increase in AgeAccelGrim2 was associated with an elevated risk of all-cause mortality (HR 1.35, 95% CI 1.23–1.49), cardiovascular mortality (HR 1.50, 95% CI 1.25–1.80), and non-cardiovascular mortality (HR 1.30, 95% CI 1.16–1.46). These associations remained significant in participants with diabetes and pre-diabetes. Mediation analysis revealed that AgeAccelGrim2 significantly mediates the association between health-related exposures (including the Oxidative Balance Score, Life’s Simple 7 score, and frailty score) and all-cause mortality in diabetes and pre-diabetes populations. Conclusions AgeAccelGrim2 could serve as a valuable biomarker for mortality risk specific to populations with diabetes and pre-diabetes, offering potential applications in personalized management strategies and risk stratification.https://doi.org/10.1186/s13148-025-01886-0DNA-methylation ageDNA-methylation age accelerationGrimAge2MortAgeAccelGrim2DiabetesPre-diabetes
spellingShingle Shuang Wu
Ziyi Zhong
Yimeng Wang
Jingyang Wang
Siqi Lyu
Hongyu Liu
Yang Chen
Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES program
Clinical Epigenetics
DNA-methylation age
DNA-methylation age acceleration
GrimAge2Mort
AgeAccelGrim2
Diabetes
Pre-diabetes
title Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES program
title_full Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES program
title_fullStr Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES program
title_full_unstemmed Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES program
title_short Unveiling the impact of DNA-methylation age acceleration on mortality risk in diabetes and pre-diabetes: insights from the US NHANES program
title_sort unveiling the impact of dna methylation age acceleration on mortality risk in diabetes and pre diabetes insights from the us nhanes program
topic DNA-methylation age
DNA-methylation age acceleration
GrimAge2Mort
AgeAccelGrim2
Diabetes
Pre-diabetes
url https://doi.org/10.1186/s13148-025-01886-0
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