Chronological age (CA) is the age given in years since birth whereas biological age (BA) is based on quantifiable changes on a cellular level measured through biomarkers. BA has a strong correlation with morbidity and mortality accounting for individual differences in the rate of aging and longevity. Since type 2 diabetes (T2D) is associated with increased morbidity and mortality, we hypothesized that BA would be increased in T2D diagnosed individuals and could be calculated with biomarkers from routine visits. In this study, we obtained deidentified data from three cohorts: (1) T2D (n= 686), (2) T1D (n= 540) (as a metabolic control) from Joslin Diabetes Center and (3) nondiabetics (n= 522) from the 2017-2018 National Health and Nutrition Examination Survey. Ages ranged from 20-80 years and for analysis, persons with diabetes were matched by age and gender to subjects without diabetes. Eight clinical biomarkers significantly correlated with CA in people without diabetes (p-values from 1.1 x10-98 to 5.6 x10-3). The Klemera and Doubal method (KDM) was used to calculate BA and results were confirmed using multiple linear regression. We observed a strong correlation between CA and BA in people without diabetes (R2 = 0.94, p< 0.0001) validating the biomarkers and KDM in our population. BA of people with T2D was, on average, 12 years higher than people without diabetes (p= 5.2 x10-187). BA of people with T1D was 15 years higher (p= 2.3 x10-236). The biomarkers with the strongest correlation to increased BA in T2D were systolic blood pressure (R2= 0.29, p< 2 x10-16) and A1c (R2= 0.27, p< 2 x10-16), suggesting that BA is dynamic and can be modified. Linear regression confirmed a significant increase of BA in persons with diabetes.

In conclusion, increased BA in people with diabetes suggests accelerated aging, a critical concept for integrating the cellular understanding of aging with the environment and which can enhance future research on the relation between aging biology and diabetes.

Disclosure

N. Bahour: None. C. Aguayo-mazzucato: Consultant; Self; eGenesis.

Funding

Joslin Diabetes Center (to C.A-M.)

© 2021 by the American Diabetes Association
2021
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