Introduction
Method
Participants and study design
Fasting insulin and fasting glucose measurements
Biological age and superannuated aging determination
Name of biomarkers | Abbreviations | |
---|---|---|
1 | Systolic blood pressure | SBP |
2 | Blood urea nitrogen | BUN |
3 | Serum c-reactive protein | CRP |
4 | Glycosylated hemoglobin | Hb1Ac |
5 | Serum creatinine | / |
6 | Serum alkaline phosphatase | ALP |
7 | Serum albumin | / |
8 | Serum total cholesterol | TC |
Covariate selection and definitions
Statistical analysis
Results
Description of the basic characteristics of the population
Variable | Total (n = 12,266) | Non-advanced aging (n = 6777) | Advanced aging (n = 5489) | P-value |
---|---|---|---|---|
Age, mean ± SD | 46.4 (0.3) | 47.7 (0.3) | 44.6 (0.4) | < 0.0001 |
Sex, n (%) | < 0.0001 | |||
Female | 6343 (51.4) | 4124 (62.2) | 2219 (37.5) | |
Male | 5923 (48.6) | 2653 (37.8) | 3270 (62.5) | |
PIR, mean ± SD | 3.0 ± 0.0 | 3.1 ± 0.0 | 2.9 ± 0.0 | < 0.0001 |
BMI (kg/m2),mean ± SD | 28.3 ± 0.1 | 27.2 ± 0.1 | 29.7 ± 0.1 | < 0.0001 |
Ethnic, n (%) | < 0.0001 | |||
Mexican American | 2589 (7.8) | 1397 (7.2) | 1192 (8.7) | |
Non-Hispanic Black | 2173 (10.5) | 996 (8.5) | 1177 (13.0) | |
Non-Hispanic White | 6182 (71.5) | 3647 (74.6) | 2535 (67.6) | |
Other Hispanic | 838 (4.8) | 481 (4.5) | 357 (5.2) | |
Other Races | 484 (5.4) | 256 (5.2) | 228 (5.5) | |
Marital status, n (%) | < 0.0001 | |||
Divorced | 1139 (9.2) | 683 (10.5) | 456 (7.8) | |
Living with partner | 867 (7.2) | 430 (6.5) | 437 (8.5) | |
Married | 6769 (57.5) | 3908 (62.0) | 2861 (54.2) | |
Never married | 1839 (15.9) | 831 (12.5) | 1008 (21.0) | |
Separated | 385 (2.5) | 229 (2.6) | 156 (2.4) | |
Widowed | 1073 (5.8) | 575 (5.9) | 498 (6.1) | |
Alcohol use, n (%) | < 0.0001 | |||
Former | 2389 (16.4) | 1272 (16.3) | 1117 (18.2) | |
Heavy | 2307 (19.8) | 1197 (18.9) | 1110 (22.8) | |
Mild | 3787 (33.8) | 2150 (36.8) | 1637 (33.2) | |
Moderate | 1586 (15.0) | 934 (17.0) | 652 (14.0) | |
Never | 1631 (10.9) | 902 (11.1) | 729 (11.8) | |
Smoking, n (%) | 0.53 | |||
Former | 3241 (25.6) | 1822 (26.1) | 1419 (25.0) | |
Never | 6445 (51.4) | 3526 (51.1) | 2919 (52.0) | |
Now | 2569 (22.9) | 1423 (22.9) | 1146 (23.1) | |
ALT (U/L), median (IQR) | 21.0 (16.0,29.0) | 20.0 (16.0,26.0) | 24.0 (18.0,33.0) | < 0.0001 |
AST (U/L), median (IQR) | 23.0 (19.0,27.0) | 22.0 (19.0,26.0) | 23.0 (20.0,28.0) | < 0.0001 |
HDL (mmol/L), median (IQR) | 1.3 (1.1,1.6) | 1.4 (1.1,1.7) | 1.2 (1.0,1.5) | < 0.0001 |
TG (mmol/L), median (IQR) | 1.2 (0.8,1.8) | 1.1 (0.8,1.6) | 1.3 (0.9,2.0) | < 0.0001 |
HOMA-IR, mean ± SD | 3.1 ± 0.0 | 2.6 ± 0.0 | 3.9 ± 0.1 | < 0.0001 |
Univariate analyses
Variable | β (95% CI) | P-value |
---|---|---|
Sex | ||
Female | 0 (ref) | |
Male | 1.9 (1.3,2.5) | < 0.0001 |
PIR | 0.3 (0.0,0.6) | 0.03 |
BMI | 0.4 (0.4,0.5) | < 0.0001 |
Ethnic | ||
Mexican American | 0 (ref) | |
Non-Hispanic Black | 5.5 (4.0,7.0) | < 0.0001 |
Non-Hispanic White | 7.7 (6.5,9.0) | < 0.0001 |
Other Hispanic | 3.1 (0.6,5.6) | 0.02 |
Other Races | 2.7 (0.5,4.8) | 0.02 |
Marital status | ||
Divorced | 0 (ref) | |
Living with partner | − 13.1 (− 14.7, − 11.4) | < 0.0001 |
Married | − 1.2 ( − 2.6, 0.2) | 0.08 |
Never married | − 16.2 (− 17.5, − 14.9) | < 0.0001 |
Separated | − 7.0 ( − 9.0, − 5.0) | < 0.0001 |
Widowed | 23.3 (21.4, 25.1) | < 0.0001 |
Alcohol. Use | ||
Former | 0 (ref) | |
Heavy | − 16.3 (− 17.4, − 15.2) | < 0.0001 |
Mild | − 5.7 ( − 6.8, − 4.7) | < 0.0001 |
Moderate | − 12.6 (− 13.9, − 11.4) | < 0.0001 |
Never | − 5.0 ( − 7.0, − 2.8) | < 0.0001 |
Smoking | ||
Former | 0 (ref) | |
Never | − 8.4 ( − 9.3, − 7.4) | < 0.0001 |
Now | − 12.1 (− 13.0, − 11.1) | < 0.0001 |
ALT | 0.0 (0.0,0.0) | 0.05 |
AST | 0.0 (0.0,0.1) | < 0.001 |
HDL | 1.2 (0.4,2.0) | 0.01 |
TG | 1.9 (1.4,2.5) | < 0.0001 |
Variable | OR (95% CI) | P-value |
---|---|---|
Sex | ||
Female | 1 (ref) | |
Male | 2.7 (2.5,3.0) | < 0.0001 |
PIR | 0.9 (0.9,0.9) | < 0.0001 |
BMI | 1.1 (1.1,1.1) | < 0.0001 |
Ethnic | ||
Mexican American | 1 (ref) | |
Non-Hispanic Black | 1.3 (1.1,1.4) | < 0.001 |
Non-Hispanic White | 0.8 (0.7,0.8) | < 0.0001 |
Other Hispanic | 1.0 (0.7,1.2) | 0.74 |
Other Races | 0.9 (0.7,1.1) | 0.32 |
Marital status | ||
Divorced | 1 (ref) | |
Living with partner | 1.8 (1.4,2.2) | < 0.0001 |
Married | 1.2 (1.0,1.4) | 0.03 |
Never married | 2.3 (1.9,2.7) | < 0.0001 |
Separated | 1.2 (0.9,1.6) | 0.15 |
Widowed | 1.4 (1.1,1.8) | 0.01 |
Alcohol use | ||
Former | 1 (ref) | |
Heavy | 1.1 (0.9,1.3) | 0.33 |
Mild | 0.8 (0.7,0.9) | 0.003 |
Moderate | 0.7 (0.6,0.9) | < 0.0001 |
Never | 1.0 (0.8,1.1) | 0.60 |
Smoking | ||
Former | 1 (ref) | |
Never | 1.1 (1.0,1.2) | 0.24 |
Now | 1.1 (0.9,1.2) | 0.46 |
ALT | 1.0 (1.0,1.0) | < 0.0001 |
AST | 1.0 (1.0,1.0) | < 0.0001 |
HDL | 0.5 (0.4,0.5) | < 0.0001 |
TG | 1.3 (1.3,1.4) | < 0.0001 |
Multivariate analysis
Variable | Model 1 | Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|---|---|
β (95%) | P-value | β (95%) | P-value | β (95%) | P-value | β (95%) | P-value | |
HOMA-IR | 0.8 (0.7,1.0) | < 0.001 | 0.9 (0.8,1.0) | < 0.001 | 0.6 (0.5,0.7) | < 0.001 | 0.5 (0.4,0.6) | < 0.001 |
HOMA-IR group | ||||||||
Q1 | 0 (Ref) | 0 (Ref) | 0 (Ref) | 0 (Ref) | ||||
Q2 | 2.8 (1.9,3.8) | < 0.001 | 3.0 (2.1,3.9) | < 0.001 | 1.8 (1.0,2.6) | < 0.001 | 2.1 (1.3,3.0) | < 0.001 |
Q3 | 5.7 (4.7,6.6) | < 0.001 | 6.1 (5.2,7.1) | < 0.001 | 4.0 (3.1,4.9) | < 0.001 | 4.1 (3.1,5.2) | < 0.001 |
Q4 | 9.6 (8.6,10.5) | < 0.001 | 10.0 (9.1,11.0) | < 0.001 | 7.0 (6.3,7.8) | < 0.001 | 6.9 (6.0,7.9) | < 0.001 |
P for trend | < 0.001 | < 0.001 | < 0.001 | < 0.001 |
Variable | Model 1 | Model 2 | Model 3 | Model 4 | ||||
---|---|---|---|---|---|---|---|---|
OR (95%) | P-value | OR (95%) | P-value | OR (95%) | P-value | OR (95%) | P-value | |
HOMA-IR | 1.2 (1.1,1.2) | < 0.001 | 1.1 (1.1,1.2) | < 0.001 | 1.1 (1.1,1.2) | < 0.001 | 1.0 (1.0,1.1) | < 0.001 |
HOMA-IR group | ||||||||
Q1 | 1 (Ref) | 1 (Ref) | 1 (Ref) | 1 (Ref) | ||||
Q2 | 1.5 (1.3,1.7) | < 0.001 | 1.4 (1.23,1.6) | < 0.001 | 1.4 (1.2,1.7) | < 0.001 | 1.2 (1.0,1.5) | < 0.001 |
Q3 | 2.0 (1.8,2.3) | < 0.001 | 1.9 (1.6,2.1) | < 0.001 | 1.9 (1.6,2.2) | < 0.001 | 1.3 (1.1,1.5) | < 0.001 |
Q4 | 3.2 (2.8,3.7) | < 0.001 | 3.0 (2.6,3.4) | < 0.001 | 2.9 (2.5,3.4) | < 0.001 | 1.6 (1.3,1.9) | < 0.001 |
p for trend | < 0.001 | < 0.001 | < 0.001 | < 0.001 |
Curve fitting
Stratified analysis
Characteristic | No. of participants | β (95% CI) | P | P for interaction |
---|---|---|---|---|
Sex | < 0.0001 | |||
Female | 6343 | 0.8 (0.6, 1.1) | < 0.0001 | |
Male | 5923 | 0.5 (0.3, 0.6) | < 0.0001 | |
Smoke | 0.4 | |||
Former | 3241 | 0.5 (0.2, 0.8) | < 0.001 | |
Never | 6445 | 0.5 (0.3, 0.7) | < 0.0001 | |
Now | 2569 | 0.8 (0.5, 1.0) | < 0.0001 | |
BMI | < 0.001 | |||
< 18.5 | 181 | 0.7 ( − 2.6, 4.0) | 0.6 | |
≥ 18.5, < 24 | 2626 | 1.2 (0.4, 2.0) | 0.004 | |
≥ 24, < 28 | 3509 | 1.4 (1.0, 1.8) | < 0.0001 | |
≥ 28 | 5780 | 0.5 (0.4, 0.6) | < 0.0001 | |
Ethnic | 0.1 | |||
Mexican American | 2589 | 0.5 (0.3, 0.8) | < 0.001 | |
Non-Hispanic Black | 2173 | 0.5 (0.3, 0.8) | < 0.001 | |
Non-Hispanic White | 6182 | 0.6 (0.4, 0.7) | < 0.0001 | |
Other Hispanic | 838 | 0.3 (0.0, 0.5) | 0.1 | |
Other Race | 484 | 1 (0.5, 1.6) | < 0.001 | |
Alcohol use | 0.03 | |||
Former | 2389 | 0.3 (0.2, 0.5) | < 0.0001 | |
Heavy | 2703 | 0.5 (0.3, 0.7) | < 0.0001 | |
Mild | 3787 | 0.8 (0.6, 1.1) | < 0.0001 | |
Moderate | 1586 | 0.8 (0.4, 1.2) | < 0.001 | |
Never | 1631 | 0.6 (0.3, 1.0) | < 0.001 |
Characteristic | No. of participants | OR (95% CI) | P | P for interaction |
---|---|---|---|---|
Sex | 0.001 | |||
Male | 6343 | 1.1 (1.0,1.1) | < 0.001 | |
Female | 5923 | 1.1 (1.1,1.1) | < 0.0001 | |
Smoke | 0.3 | |||
Former | 3241 | 1.1 (1.0,1.1) | < 0.001 | |
Never | 6445 | 1.1 (1.0,1.1) | 0.002 | |
Now | 2569 | 1.1 (1.1,1.2) | < 0.0001 | |
BMI | 0.02 | |||
< 18.5 | 181 | 1.3 (0.5, 3.2) | 0.5 | |
≥ 18.5, < 24 | 2626 | 1.2 (1.1,1.4) | < 0.001 | |
≥ 24, < 28 | 3509 | 1.1 (1.0,1.1) | 0.01 | |
≥ 28 | 5780 | 1.1 (1.0,1.1) | < 0.0001 | |
Ethnic | 0.5 | |||
Mexican American | 2589 | 1.1 (1.0,1.2) | < 0.001 | |
Non-Hispanic Black | 2173 | 1.1 (1.0,1.1) | 0.01 | |
Non-Hispanic White | 6182 | 1.1 (1.0,1.1) | < 0.0001 | |
Other Hispanic | 838 | 1.2 (1.1, 1.3) | 0.004 | |
Other Race | 484 | 1.0 (0.9, 1.2) | 0.6 | |
Alcohol use | 0.2 | |||
Former | 2389 | 1.0 (1.0,1.1) | 0.1 | |
Heavy | 2703 | 1.1 (1.0,1.1) | 0.001 | |
Mild | 3787 | 1.1 (1.0,1.1) | 0.01 | |
Moderate | 1586 | 1.1 (1.0,1.2) | 0.01 | |
Never | 1631 | 1.1 (1.0,1.2) | 0.01 |