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J Clin Endocrinol Metab. 2019 Jul 1;104(7):3012-3024. doi: 10.1210/jc.2018-02076.

Epigenetic Age Acceleration in Adolescence Associates With BMI, Inflammation, and Risk Score for Middle Age Cardiovascular Disease.

Author information

Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, Australia.
University of Southampton, Southampton, United Kingdom.
Medical School, University of Western Australia, Perth, Western Australia Australia.
Centre for Molecular and Medical Research, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Environmental and Genetic Epidemiology Research, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
School of Medicine and Public Health, Faculty of Medicine and Health, University of Newcastle, Callaghan, New South Wales, Australia.
Curtin/UWA Centre for Genetic Origins of Health and Disease, School of Biomedical Sciences, University of Western Australia, Crawley, Western Australia, Australia.
School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Western Australia, Australia.



"Accelerated aging," assessed by adult DNA methylation, predicts cardiovascular disease (CVD). Adolescent accelerated aging might predict CVD earlier. We investigated whether epigenetic age acceleration (assessed age, 17 years) was associated with adiposity/CVD risk measured (ages 17, 20, and 22 years) and projected CVD by middle age.


DNA methylation measured in peripheral blood provided two estimates of epigenetic age acceleration: intrinsic (IEAA; preserved across cell types) and extrinsic (EEAA; dependent on cell admixture and methylation levels within each cell type). Adiposity was assessed by anthropometry, ultrasound, and dual-energy x-ray absorptiometry (ages 17, 20, and 22 years). CVD risk factors [lipids, homeostatic model assessment of insulin resistance (HOMA-IR), blood pressure, inflammatory markers] were assessed at age 17 years. CVD development by age 47 years was calculated by Framingham algorithms. Results are presented as regression coefficients per 5-year epigenetic age acceleration (IEAA/EEAA) for adiposity, CVD risk factors, and CVD development.


In 995 participants (49.6% female; age, 17.3 ± 0.6 years), EEAA (per 5 years) was associated with increased body mass index (BMI) of 2.4% (95% CI, 1.2% to 3.6%) and 2.4% (0.8% to 3.9%) at 17 and 22 years, respectively. EEAA was associated with increases of 23% (3% to 33%) in high-sensitivity C-reactive protein, 10% (4% to 17%) in interferon-γ-inducible protein of 10 kDa, and 4% (2% to 6%) in soluble TNF receptor 2, adjusted for BMI and HOMA-IR. EEAA (per 5 years) results in a 4% increase in hard endpoints of CVD by 47 years of age and a 3% increase, after adjustment for conventional risk factors.


Accelerated epigenetic age in adolescence was associated with inflammation, BMI measured 5 years later, and probability of middle age CVD. Irrespective of whether this is cause or effect, assessing epigenetic age might refine disease prediction.

[Available on 2020-01-01]

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