Association between biological aging and diabetic retinopathy

Area of Science:

• Ophthalmology
• Gerontology
• Endocrinology

Background:

• Diabetic retinopathy (DR) is a significant complication of diabetes mellitus (DM).
• The impact of biological aging on DR risk is not fully understood.
• Chronological age (CA) may not fully capture aging-related DR risks.

Purpose of the Study:

• To investigate the association between biological aging metrics (biological age (BA) and phenotypic age (PA)) and diabetic retinopathy (DR).
• To compare the predictive power of BA and PA against CA for DR risk.
• To evaluate the clinical utility of BA and PA in DR prediction.

Main Methods:

• Utilized data from the National Health and Nutrition Survey (2005-2008).
• Calculated BA and PA from clinical markers.
• Employed survey-weighted multivariable logistic regression and restricted cubic splines for analysis.
• Assessed model performance using receiver operating characteristic (ROC) curves and decision curve analysis (DCA).

Main Results:

• Biological age (OR=1.12) and phenotypic age (OR=1.11) were significantly associated with DR, while chronological age was not (OR=1.01).
• BA and PA demonstrated superior predictive capability and clinical utility for DR compared to CA.
• Findings were consistent across subgroups, including those with diabetes mellitus adjusted for insulin use.

Conclusions:

• Biological aging, as indicated by BA and PA, is a stronger predictor of diabetic retinopathy risk than chronological age.
• BA and PA offer enhanced clinical utility for DR risk assessment.
• Emphasizes the importance of considering biological aging in DR prevention strategies and potential anti-aging interventions.