Clinical Biomarker-Based Biological Aging and the Risk of Abdominal Aortic Aneurysm: A Prospective Cohort Study

BackgroundCompared to chronological age, biological age (BA), a concept introduced in recent years, more accurately reflects the true aging status of the body. While biological aging has been found to be associated with various cardiovascular diseases, its relationship with abdominal aortic aneurysm (AAA) remains unclear. MethodsThis study utilized data extracted from UK Biobank for analysis. Telomere length (TL), and BA acceleration calculated using the Klemera-Doubal (KDM) and PhenoAge methods, were employed as surrogate measures to assess biological aging. Cox regression was primarily performed to explore the association between biological aging and AAA risk. Genetic susceptibility was assessed by constructing a polygenic risk score (PRS). ResultsThis study included 311,646 participants, predominantly women and White, with a median age of 58 years. During a median follow-up of 12.54 years, 1,339 new cases of AAA (4.3{per thousand}) were reported. Each standard deviation (SD) decrease in TL was associated with a 20% increased risk of AAA (HR=1.20, 95% CI=1.14-1.27); each SD increase in KDM-BA acceleration was associated with a 21% increased risk (HR=1.21, 95% CI=1.12-1.29); and each SD increase in PhenoAge acceleration was associated with a 40% increased risk (HR=1.40, 95% CI=1.32-1.48). These associations were independent of genetic risk, as assessed by the PRS, and demonstrated a joint effect with genetic predisposition on the long-term risk of AAA. ConclusionAccelerated biological aging was longitudinally associated with an increased risk of AAA, suggesting it may be a significant factor and potential biomarker for the occurrence of the condition.