Age-specific Association Research Articles

Age-specific association between meal-skipping patterns and the risk of hyperglycemia in Korean adults: a national cross-sectional study using the KNHANES data

BackgroundGlucose metabolism regulation is influenced by age and meal skipping, although research on their interplay with hyperglycemia remains limited. This study aims to explore the intricate relationship between meal-skipping patterns and hyperglycemia risk across distinct age groups in South Korean adults.MethodsUtilizing data from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2013 to 2020, comprising 28,530 individuals aged 19 years and older, this study employed multivariable logistic regression models to examine the associations between meal-skipping patterns and the risk of hyperglycemia.ResultsMeal-skipping patterns were categorized into three groups: no skipping (NS), skipping breakfast (SB), and skipping dinner (SD). Age groups were defined as “young” (aged 19–44), “middle-aged” (aged 45–64), and “elderly” adults (over 65 years old). Among “young” adults, SB was associated with a 1.33-fold higher risk of hyperglycemia (OR = 1.33, 95% CI = 1.14–1.54) compared to NS. Conversely, in “elderly” adults, SD was linked to a 0.49-fold reduced risk (95% CI = 0.29–0.82) when compared to NS. Additionally, we observed that the Korean Health Eating Index (KHEI) scores, representing the quality of diet on a scale of 0 to 100, were consistently lower in SB compared to NS across all age groups. Intriguingly, specifically among the “elderly” group, this score was higher in SD compared to NS (p < 0.001).ConclusionsThis study demonstrates age-specific variations in the association between meal-skipping patterns and the risk of hyperglycemia.

Age-specific association between visit-to-visit blood pressure variability and hearing loss: A population-based cohort study

Abstract Background and Objectives Hearing loss is common and undertreated, and the impact of blood pressure variability (BPV) on the development of hearing loss remains unclear. We aimed to examine the age-specific association between visit-to-visit BPV and hearing loss. Research Design and Methods This nationally representative cohort study included 3939 adults over 50 years from the Health and Retirement Study in the US. Variabilities of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed by standard deviation (SD), coefficient of variation (CV) and variability independent of the mean (VIM), using SBP and DBP from three visits. Hearing loss was assessed by self-rated questions. Cox proportional risk models were used to evaluate age-specific associations (50-64, 65-79 and ≥80 years) between BPV and hearing loss. The generalized additive Cox models were further used to visualize the combined effect of age and BPV. Results During the follow-up up to 7.0 years, 700 participants developed hearing loss. Among people aged under 65 years, we observed a 36% increased risk of hearing loss with per SD increment in VIM of SBP (HR per SD 1.36, 95% CI 1.13-1.63) and a slightly significant association between VIM of DBP (HR per SD 1.21, 95% CI 1.01-1.45) and hearing loss. We did not observe significant associations among groups aged over 65 years (P&amp;gt;0.05). The generalized additive Cox models also showed younger participants had stronger associations between BPV and hearing loss. Discussion and Implications Higher visit-to-visit variabilities of SBP were associated with an increased risk of hearing loss in middle-aged adults (50-65 years). Intervention in early BPV may help decrease hearing loss in adults aged over 50 years.

An early-onset specific polygenic risk score optimizes age-based risk estimate and stratification of prostate cancer: population-based cohort study

BackgroundEarly-onset prostate cancer (EOPC, ≤ 55 years) has a unique clinical entity harboring high genetic risk, but the majority of EOPC patients still substantial opportunity to be early-detected thus suffering an unfavorable prognosis. A refined understanding of age-based polygenic risk score (PRS) for prostate cancer (PCa) would be essential for personalized risk stratification.MethodsWe included 167,517 male participants [4882 cases including 205 EOPC and 4677 late-onset PCa (LOPC)] from UK Biobank. A General-, an EOPC- and an LOPC-PRS were derived from age-specific genome-wide association studies. Weighted Cox proportional hazard models were applied to estimate the risk of PCa associated with PRSs. The discriminatory capability of PRSs were validated using time-dependent receiver operating characteristic (ROC) curves with additional 4238 males from PLCO and TCGA. Phenome-wide association studies underlying Mendelian Randomization were conducted to discover EOPC linking phenotypes.ResultsThe 269-PRS calculated via well-established risk variants was more strongly associated with risk of EOPC [hazard ratio (HR) = 2.35, 95% confidence interval (CI) 1.99–2.78] than LOPC (HR = 1.95, 95% CI 1.89–2.01; I2 = 79%). EOPC-PRS was dramatically related to EOPC risk (HR = 4.70, 95% CI 3.98–5.54) but not to LOPC (HR = 0.98, 95% CI 0.96–1.01), while LOPC-PRS had similar risk estimates for EOPC and LOPC (I2 = 0%). Particularly, EOPC-PRS performed optimal discriminatory capability for EOPC (area under the ROC = 0.613). Among the phenomic factors to PCa deposited in the platform of ProAP (Prostate cancerAge-basedPheWAS; https://mulongdu.shinyapps.io/proap), EOPC was preferentially associated with PCa family history while LOPC was prone to environmental and lifestyles exposures.ConclusionsThis study comprehensively profiled the distinct genetic and phenotypic architecture of EOPC. The EOPC-PRS may optimize risk estimate of PCa in young males, particularly those without family history, thus providing guidance for precision population stratification.

Age-specific association of physical activity on visceral obesity: Cross-sectional study

AimsObesity is a chronic disease that needs to be managed worldwide. High-intensity physical activity has a positive effect on the improvement and prevention of metabolic diseases. The purpose of this study was to investigate the age-specific association of physical activity on abdominal and visceral obesity. MethodsThe study involved 456 health check-up participants who underwent abdominal computed tomography scans for the assessment of visceral fat area from January 2017 to December 2017. Physical activity levels were categorized as none-to-low-intensity or moderate-to-vigorous-intensity based on the International Physical Activity Questionnaire. Logistic regression analysis, adjusted for covariates, assessed the association of physical activity with abdominal and visceral obesity across 10-year age intervals. ResultsThe moderate-to-vigorous physical activity group showed 56.5% visceral obesity, while the none-to-low-intensity physical activity group had 63.2%. Most age groups exhibited no significant differences in abdominal or visceral obesity according to physical activity. However, the 50 to 59 age group demonstrated a noteworthy association between visceral obesity and none-to-low-intensity physical activity (odds ratio 3.79, 95% confidence interval 1.12–12.84). ConclusionsThis study highlights a distinct age-related response to physical activity, emphasizing the 50 to 59 age group's significant association between visceral obesity and none-to-low-intensity physical activity.

Neurodevelopmental trajectories of cerebellar grey matter associated with verbal abilities in males with autism spectrum disorder

Autism spectrum disorder (ASD) is a neurodevelopmental condition frequently associated with structural cerebellar abnormalities. Whether cerebellar grey matter volumes (GMV) are linked to verbal impairments remains controversial. Here, the association between cerebellar GMV and verbal abilities in ASD was examined across the lifespan. Lobular segmentation of the cerebellum was performed on structural MRI scans from the ABIDE I dataset in male individuals with ASD (N=144, age: 8.5–64.0 years) and neurotypical controls (N=188; age: 8.0–56.2 years). Stepwise linear mixed effects modeling including group (ASD vs. neurotypical controls), lobule-wise GMV, and age was performed to identify cerebellar lobules which best predicted verbal abilities as measured by verbal IQ (VIQ). An age-specific association between VIQ and GMV of bilateral Crus II was found in ASD relative to neurotypical controls. In children with ASD, higher VIQ was associated with larger GMV of left Crus II but smaller GMV of right Crus II. By contrast, in adults with ASD, higher VIQ was associated with smaller GMV of left Crus II and larger GMV of right Crus II. These findings indicate that relative to the contralateral hemisphere, an initial reliance on the language-nonspecific left cerebellar hemisphere is offset by more typical right-lateralization in adulthood.

Age-Specific Association of Co-Morbidity With Home-Time After Acute Stroke.

To examine the association of co-morbidity with home-time after acute stroke and whether the association is influenced by age. We conducted a province-wide study using linked administrative databases to identify all admissions for first acute ischemic stroke or intracerebral hemorrhage between 2007 and 2018 in Alberta, Canada. We used ischemic stroke-weighted Charlson Co-morbidity Index of 3 or more to identify those with severe co-morbidity. We used zero-inflated negative binomial models to determine the association of severe co-morbidity with 90-day and 1-year home-time, and logistic models for achieving ≥ 80 out of 90 days of home-time, assessing for effect modification by age and adjusting for sex, stroke type, comprehensive stroke center care, hypertension, atrial fibrillation, year of study, and separately adjusting for estimated stroke severity. We also evaluated individual co-morbidities. Among 28,672 patients in our final cohort, severe co-morbidity was present in 27.7% and was associated with lower home-time, with a greater number of days lost at younger age (-13 days at age < 60 compared to -7 days at age 80+ years for 90-day home-time; -69 days at age < 60 compared to -51 days at age 80+ years for 1-year home-time). The reduction in probability of achieving ≥ 80 days of home-time was also greater at younger age (-22.7% at age < 60 years compared to -9.0% at age 80+ years). Results were attenuated but remained significant after adjusting for estimated stroke severity and excluding those who died. Myocardial infarction, diabetes, and cancer/metastases had a greater association with lower home-time at younger age, and those with dementia had the greatest reduction in home time. Severe co-morbidity in acute stroke is associated with lower home-time, more strongly at younger age.

Age-wise examination of the association of obesity based on body mass index and waist circumference with metabolic diseases in comprehensive health checkup participants.

Body mass index and waist circumference are used for obesity diagnosis and screening of visceral fat; however, their evidence in older adults is insufficient. This study investigated the age-specific association of body mass index and waist circumference with metabolic diseases, assessing their applicability as diagnostic criteria for individuals aged ≥65years. Analysis included 46,324 individuals aged ≥18years, categorized into five age groups: 18-44, 45-54, 55-64, 65-74, and ≥75years. Logistic regression analyses identified associations between obesity and metabolic diseases, stratified by age and sex. Men with obesity based on body mass index had a significantly high risk of hypertension, diabetes mellitus, and dyslipidemia across all age groups (all, p<0.05). Obesity based on waist circumference was significantly positively associated with all metabolic diseases (all, p<0.05). Women with obesity based on body mass index and waist circumference had a significantly high risk of all metabolic diseases across all age groups (all, p<0.05), except for diabetes mellitus in individuals aged ≥75years. Participants with obesity based on body mass index and waist circumference exhibited a high risk of hypertension, diabetes mellitus, and dyslipidemia among those aged 18-74years and men aged ≥75years. This study contributes to the early prevention and control of metabolic diseases.

Maternal age-specific risks for adverse birth weights according to gestational weight gain: a prospective cohort in Chinese women older than 30

BackgroundIt is unclear whether the effects of abnormal gestational weight gain (GWG) on birth outcomes are differently in women with different maternal ages. This study aimed to investigate maternal age-specific association between GWG and adverse birth weights in Chinese women older than 30.Methods19,854 mother-child dyads were selected from a prospective cohort study in Southwest China between 2019 and 2022. Logistic regression model was used to assess the association between GWG, which defined by the 2009 Institute of Medicine guidelines, and adverse birth weights including large- and small-for-gestational-age (LGA and SGA), stratified by maternal age (31–34 years and ≥ 35 years).ResultsIn both maternal age groups, excessive and insufficient GWG were associated with increased odds of LGA and SGA, respectively. After women were categorized by pre-pregnancy body mass index, the associations remained significant in women aged 31–34 years, whereas for women aged ≥ 35 years, the association between excessive GWG and the risk of LGA was only significant in normal weight and overweight/obese women, and the significant effect of insufficient GWG on the risk of SGA was only observed in underweight and overweight/obese women. Moreover, among overweight/obese women, the magnitude of the association between insufficient GWG and the risk of SGA was greater in those aged ≥ 35 years (31–34 years: OR 2.08, 95% CI 1.19–3.55; ≥35 years: OR 2.65, 95% CI 1.47–4.74), while the impact of excessive GWG on the risk of LGA was more pronounced in those aged 31–34 years (31–34 years: OR 2.18, 95% CI 1.68–2.88; ≥35 years: OR 1.71, 95% CI 1.30–2.25).ConclusionsThe stronger associations between abnormal GWG and adverse birth weights were mainly observed in women aged 31–34 years, and more attention should be paid to this age group.

Loneliness status transitions and risk of cardiovascular disease among middle-aged and older adults

Background and aimsLoneliness is a risk factor for cardiovascular disease (CVD), and the levels at which individuals experience it can transition over time. However, the impact of increased loneliness or decreased loneliness on later CVD risk remains unexplored. We aimed to identify the age-specific association between loneliness status transitions and subsequent CVD incidences in middle-aged and older adults. Methods and resultsData was extracted from the China Health and Retirement Longitudinal Study (CHARLS) on 8463 adults to evaluate how loneliness status transitions across two data collection points were associated with the subsequent CVD incidence at a five-year follow-up. Loneliness status transitions were divided into four categories: stable low loneliness, decreased loneliness, increased loneliness, and stable high loneliness. Data were analyzed using a Cox-proportional hazards model with age subgroups, accounting for covariates at baseline. During follow-up, the incidence rate of CVD per 1000 person-years was lower for the stable low loneliness group and decreased loneliness group compared to the increased loneliness and stable high loneliness group. Increased loneliness is associated with the highest risk of overall CVD and heart disease (HR 2.44, P < 0.001; HR 2.34, P < 0.001), while stable high loneliness is associated with the highest risk of stroke among the four loneliness categories (HR 4.29, P < 0.05). The age-specific analyses revealed no statistically significant interaction in terms of loneliness status transitions and age group. ConclusionIncreased loneliness and stable high loneliness are associated with higher CVD risk. In clinical practice, it is important to monitor patients’ loneliness status transitions to reduce CVD incidences.

Age-specific association between thyroid autoimmunity and hypothyroidism in Chinese adults aged over 65 years: a cross-sectional study.

The correlation between thyroid autoimmune (TAI) disease and hypothyroidism in the elderly of different ages remains unclear. This study aimed to investigate the epidemiological characteristics of hypothyroidism, including subclinical hypothyroidism (Shypo) and overt hypothyroidism (Ohypo) in those aged ≥65 years from iodine-adequate areas and reveal the correlation between TAI and hypothyroidism in the elderly of different ages. It was a cross-sectional study involving 2,443 subjects aged ≥65 years from two iodine-adequate areas in China by cluster sampling. They were assigned to the 65-69-, 70-79-, and ≥80-year-old age group. All subjects were surveyed by questionnaires and received physical examinations, laboratory testing, and thyroid ultrasound. Epidemiological characteristics of thyroid diseases in the elderly were compared among the three groups. Risk factors for hypothyroidism were predicted by binary logistic regression analysis. The median urinary iodine level was 238.70 (197.00, 273.70) μg/L. Thyroid peroxidase antibody or thyroglobulin antibody positivity (11.87%) and Shypo (9.13%) were common in the elderly. The prevalence of hypothyroidism in the elderly increases with age. TAI was a risk factor for Shypo (OR, 1.94; 95% CI, 1.35, 2.80; p < 0.01) and Ohypo (OR, 7.64; 95% CI, 3.40, 17.19; p < 0.01) in elderly Chinese. There was an age-specific correlation between TAI and hypothyroidism in the elderly. However, a significant correlation was not identified between TAI and hypothyroidism in ≥80-year-old age group (p > 0.05). Hypothyroidism, particularly Shypo, is common in the elderly from iodine-adequate areas in China. TAI serves as a risk factor for hypothyroidism in the elderly, with an age-specific correlation with hypothyroidism.

Editor's Choice Articles for June.

Editor's Choice Articles for June.

Age-specific association of stage of hypertension at diagnosis with cardiovascular and all-cause mortality among elderly patients with hypertension: a cohort study

BackgroundHypertension affects 31.1% of adults worldwide, with higher prevalence of great than 60% in elderly. Advanced hypertension stage was associated with the higher risk of mortality. However, little is known about the age-specific association of stage of hypertension at diagnosis on cardiovascular mortality or all-cause mortality. Therefore, we aim to explore this age-specific association among the hypertensive elderly through stratified and interaction analyses.MethodsThis cohort study included 125,978 elderly hypertensive patients aged 60+ years from Shanghai of China. Cox regression was used to estimate the independent and joint effect of hypertension stage and age at diagnosis on cardiovascular and all-cause mortality. Interactions were evaluated both additively and multiplicatively. Multiplicative interaction was examined by the Wald test of the interaction term. Additive interaction was assessed by relative excess risk due to interaction (RERI). All analyses were performed stratified by sex.Results28,250 patients died during the follow-up up to 8.85 years, and 13,164 died of cardiovascular events. Older age and advanced hypertension stage were risk factors of cardiovascular mortality and all-cause mortality. Besides, smoking, rarely exercise, BMI < 18.5 and diabetes were also the risk factors. When we compared stage 3 hypertension with stage 1 hypertension, hazard ratios (95% confidence interval) of cardiovascular mortality and all-cause mortality were 1.56(1.41–1.72) and 1.29(1.21–1.37) for males aged 60–69 years, 1.25(1.14–1.36) and 1.13(1.06–1.20) for males aged 70–85 years, 1.48(1.32–1.67) and 1.29(1.19–1.40) for females aged 60–69 years, and 1.19(1.10–1.29) and 1.08(1.01–1.15) for females aged 70–85 years, respectively. Negative multiplicative interaction and positive additive interaction between age at diagnosis and stage of hypertension at diagnosis on cardiovascular mortality were observed in males (HR: 0.81, 95% CI: 0.71–0.93 RERI: 0.59, 95% CI: 0.09–1.07) and females (HR: 0.81, 95% CI: 0.70–0.93 RERI: 0.66, 95% CI: 0.10–1.23).ConclusionsDiagnosed with stage 3 hypertension was associated with higher risks of cardiovascular mortality and all-cause mortality, which were stronger among patients with age at diagnosis of 60–69 years compared with those with age at diagnosis of 70–85 years. Therefore, for the younger part of the elderly, the Department of Health should pay more attention to treating patients with stage 3 hypertension.

Sex- and age-specific association between outdoor light at night and obesity in Chinese adults: A national cross-sectional study of 98,658 participants from 162 study sites.

Exposure to light at night (LAN) is a potent disruptor of the circadian system. Whether LAN exposure exerts a sex- or age-specific influence on obesity needs investigation. To estimate the sex- and age-specific associations of exposure to outdoor LAN and obesity based on a national and cross-sectional survey. The study included a nationally representative sample of 98,658 adults aged ≥ 18 years who had lived in their current residence for ≥ 6 months from 162 study sites across mainland China in 2010. Outdoor LAN exposure was estimated from satellite imaging data. General obesity was defined as body-mass index (BMI) ≥ 28 kg/m2 and central obesity was defined as waist circumference ≥ 90cm in men and ≥ 85cm in women. Linear and logistic regression models were used to examine the associations between LAN exposure and prevalent obesity in sex and age categories. A monotonically increasing association of outdoor LAN with BMI, waist circumference was observed in all sex and age categories, except for adults aged 18-39 years. Significant associations of LAN exposure with prevalent obesity were observed in each sex and age category, especially in men and older people. Per 1-quintile increase in LAN was associated with 14% increased odds of general obesity in men (odds ratio, OR=1.14, 95% confidence interval, CI=1.07-1.23) and 24% in adults aged ≥ 60 years (OR=1.24, 95% CI=1.14-1.35). Per 1-quintile increase in LAN was associated with 19% increased odds of central obesity in men (OR=1.19, 95% CI=1.11-1.26) and 26% in adults aged ≥ 60 years (OR=1.26, 95% CI=1.17-1.35). Increased chronic outdoor LAN exposure was associated with increased prevalence of obesity in sex- and age- specific Chinese populations. Public health policies on reducing light pollution at night might be considered in obesity prevention.

Association between reading and depression in Chinese adults.

Qualitative evidences have shown that having the habit of reading might be beneficial for mental health. The present study aims to examine the relationship between reading and depression. National cross-sectional survey data of adults aged >40 years in mainland China were used. The Center for Epidemiological Studies Depression Scale questionnaire was utilized to detect depression status. Multilevel binary logistic and linear regression models were employed to reveal the association, and restricted cubic spline with 4 knots was adopted to describe the non-linear association of reading quantity and depression. The prevalence of depression was 13.02% in the target population. It was found that the habit of reading was negatively associated with depression, the odds ratio was 0.809 (95% confidence interval: 0.657-0.997). Diverse association between reading and depression was observed in different age groups, and a significant association was identified among the elderly, but not in the middle-aged population. Restricted cubic spline showed several books read per year might lower the risk of depression and 20-items Center for Epidemiological Studies Depression Scale score. A lower prevalence of depression was observed in the target population. The habit of reading was negatively associated with depression. Age-specific association was observed. It is worth paying attention to the reading habit that could be beneficial in the elderly for mental health intervention, but it needs to be confirmed by experimental study.

Age-specific serum thyrotropin reference range for the diagnosis of subclinical hypothyroidism and its association with lipid profiles in the elderly population

The overdiagnosis of subclinical hypothyroidism (SCH) in the elderly has driven researchers to establish age-specific thyroid stimulating hormone (TSH) intervals to precisely evaluate the prevalence of SCH. Moreover, abnormal lipid profiles, an insidious manifestation of SCH, show various impacts on different age groups. This study aimed to establish an age-specific TSH reference range to clarify the spectrum of SCH in the elderly. The prevalence of dyslipidemia and the age-specific association between TSH and lipid profiles were analyzed to elucidate the relationship between SCH and dyslipidemia. This cross-sectional study enrolled 2460 participants aged ≥ 65 years via cluster sampling. All participants received physical, laboratory tests and thyroid ultrasound examination and completed the questionnaire. The chi-square test was used to analyze variations of dyslipidemia prevalence among different groups. The Cochran-Armitage trend test was applied for testing the linear trends of age-specific prevalence of dyslipidemia among different TSH intervals in each age group. After adjusting for confounding factors, the age-specific association between TSH and lipid profiles was identified using multi-variate linear regression analysis. The TSH reference ranges in the 65–70 age group, 71–80 age group and > 80 age group were 0.65–5.51 mIU/L, 0.85–5.89 mIU/L and 0.78–6.70 mIU/L, respectively. Using these age-specific reference ranges, the prevalence of SCH in the whole population was 3.74%, which was significantly lower than the prevalence based on the laboratory reference range (10.28%). In the 65–70 age group, only the prevalence of high total cholesterol (TC) increased significantly with the age-specific TSH intervals, and TSH was positively associated with TC and low-density lipoprotein cholesterol (LDL-C). In the 71–80 and > 80 age groups, the prevalence of high TC, high triglycerides (TGs), and high LDL-C increased significantly with elevated TSH reference ranges. The levels of TC, TGs, and LDL-C were also positively associated with TSH level in 71–80 age group. However, such an association disappeared in > 80 age group. An age-specific reference range for TSH can effectively prevent the overdiagnosis of SCH in the elderly. Aging could somewhat attenuate the impact of TSH on lipid profiles.

ODP138 Age-related Associations of LDL Cholesterol and Atherosclerotic Cardiovascular Disease: A Nationwide Population-based Cohort Study

Abstract Background No completed randomized trial exclusively incorporating the elderly has addressed the benefit of statin treatment for primary prevention until now. Therefore, consensus of major international lipid management guidelines has not been made upon lowering LDL cholesterol (LDL-C)to prevent primary atherosclerotic cardiovascular disease (ASCVD)in the older population. Question: This study aimed to investigate whether ASCVD risk according to increasing LDL-C differs between age groups. Methods Data was provided by the Health Screening Cohort of the Korean National Health Insurance Service, which is a nationwide health screening program covering the whole population with alow attrition rate. Subjects with preexisting cardiovascular disease or taking lipid-lowering drugs were excluded. Participants were followed up from January1,2011 to December31, 2015. Multivariable Cox proportional hazard regressions were performed to evaluate the relationship between LDL-C and ASCVD. Subgroup analyses were also conducted in patients with T2DM. Results The final cohort was composed of 285,119 participants with a mean age of 58.4 years and 55.2% of men. The average baseline LDL-C level was 121.5 mg/dL (standard deviation, 36.4). The proportion of individuals was 2.4% (n =6,718),9. 0% (n = 25,687), 26.6% (n = 75,981), 37.2% (n = 105,952), 20.2% (n = 57,562), and 4.6% (n = 13,219) in LDL-C ≥190, 160–189, 130–159, 100–129, 70–99, and&amp;lt;70 mg/dL, respectively. Patients with T2DM comprised 7.5% (n = 21,258) of the entire population. During a median follow-up of 6.44 years, the first ASCVD developed in8,996 participants (3.2%). All age groups showed positive associations between LDL-C and ASCVD risk, mostly with statistical significance from LDL-C of 160 mg/dL onward. ASCVD risk did not differ significantly between the age groups (P for interaction =0.62). Compared with ASCVD risk in LDL-C of 70–99 mg/dL, the risk in the highest LDL-C(≥190 mg/dL)was similar between groupsaged&amp;lt;50 and ≥70 years (adjusted hazard ratio [aHR], 1.90 [95%confidence interval (CI),1.52–2.38] and aHR, 1.86 [95% CI, 1.30–2.68], respectively). Subgroup analysis in patients with T2DM showed that 7.2% of subjects experienced incident ASCVD. Age-specific association of ASCVD risk and LDL-C in T2DM patients displayed no difference in line with the total participants(P for interaction = 0.31). Conclusions A large-scale, population-based cohort study of adults who had no previous CVD history and were not prescribed lipid-lowering drugs demonstrated that elevated LDL-C was significantly correlated with a greater risk of ASCVD in people aged≥70 years, which was comparable with the risk in younger adults. This finding spotlights the necessity of settling intensive guidance on LDL-C levels for primary CVD prevention in the elderly. Presentation: No date and time listed

Differences in the impact of impaired glucose status on clinical outcomes in younger and older adults: Over a decade of follow-up in the Tehran lipid and glucose study.

Studies found that the impact of dysglycemia on microvascular, macrovascular events and mortality outcomes were different between the younger vs. older population. We aimed to investigate the age-specific association of prediabetes with clinical outcomes including type 2 diabetes (T2DM), hypertension, chronic kidney disease (CKD), cardiovascular disease (CVD), and mortality. A total of 5,970 Iranians (3,829 women) aged ≥30 years, without T2DM, were included. The age-specific (<60 and ≥60 years; minimum p-value for interaction = 0.001) multivariable-adjusted Cox regression was done to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the impaired glucose status including impaired fasting glucose (IFG) vs. normal fasting glucose (NFG), impaired glucose tolerance (IGT) vs. normal glucose tolerance (NGT), and IFG&IGT vs. NFG/NGT with each outcome. Among individuals aged ≥60 years, the prevalence of impaired glucose status (IFG, IGT, or both) was about 2 times higher compared to those aged <60. Age-specific association between prediabetes and incident hypertension was found for those aged <60 years; [HR (95% CI); IFG: 1.38 (1.16-1.65), IGT: 1.51 (1.26-1.81), and IFG&IGT: 1.62 (1.21-2.12)]. For CVD, in all impaired glycemic states, those aged <60 were at higher significant risk [IFG: 1.39 (1.09-1.77), IGT: 1.53 (1.19-1.97), and IFG&IGT: 1.60 (1.14-2.25)]. Stratified analyses showed similar associations for IFG and IGT with non-CV mortality 1.71 (1.04-2.80) and 2.12 (1.30-3.46), respectively, and for all-cause mortality among those aged <60 years [IFG: 1.63 (1.08-2.45) and IGT: 1.82 (1.20-2.76)]. In both age groups, all glycemic status groups were significantly associated with T2DM but not with CKD and CV mortality. The high prevalence of prediabetes particularly among the elderly population, limited resources, and the observed significant age differences in the impact of prediabetes states on different clinical outcomes calls for multicomponent intervention strategies by policy health makers, including lifestyle and possible pharmacological therapy, with the priority for the young Iranian population.

Age-specific association between non-HDL-C and arterial stiffness in the Chinese population.

BackgroundWhile some epidemiological studies have found correlations between non-high-density lipoprotein cholesterol (non-HDL-C) and arterial stiffness, there are still exist controversial and age-stratified analysis are scarce yet.MethodsAll individuals in this study were recruited in the Third Xiangya Hospital of Central South University from 2012 to 2016. Arterial stiffness was defined as brachial-ankle pulse wave velocity (baPWV) ≥1,400 cm/s. Association between non-HDL-C and arterial stiffness were explored using Cox proportional-hazards model. We also conducted subanalysis stratified by age. Furthermore, restricted cubic splines were used to model exposure-response relationships in cohort sample.ResultsThis cohort study included 7,276 participants without arterial stiffness at baseline. Over a median follow-up of 1.78 years (IQR, 1.03–2.49), 1,669 participants have identified with incident arterial stiffness. In multivariable-adjusted analyses, higher non-HDL-C concentration was associated with incident arterial stiffness with an adjusted hazard ratio (HR) of 1.09 [95% confidence interval (CI), 1.02–1.17] per 1 mmol/L increase. Compared with the lowest tertile, the HR for arterial stiffness with respect to the highest tertile of non-HDL-C was 1.26 (95% CI, 1.07–1.48). The results were similar in the analysis of young participants (age <60 years).ConclusionOur study identified that non-HDL-C as a potential risk factor of arterial stiffness, especially for younger. The clinical benefits of decreasing non-HDL-C concentration should be further considered in the future.

1208-P: Age-Specific Association between Risk Factors and All-Cause and Cause-Specific Mortality in People with Type 2 Diabetes

Background: We aimed to examine age-specific association and population attributable fraction (PAF) of risk factors for all-cause and cause-specific mortality in people with type 2 diabetes. Methods: We used data from 360,202 people with type 2 diabetes who underwent metabolic assessment in 2000-20in Hong Kong. We included eight risk factors, including three baseline comorbidities: cardiovascular disease (CVD) , chronic kidney disease (CKD) and cancer; and five modifiable risk factors: suboptimal HbA1c (≥7.0%) , suboptimal blood pressure (SBP/DBP ≥140/90 mmHg) , suboptimal LDL-C (≥2.6 mmol/L) , smoking and suboptimal weight (BMI &amp;lt;24.0 or ≥28.0 kg/m2) . We used Cox regression models to compare the hazard ratios and PAFs of the risk factors for mortality risk across age groups (18-54, 55-64, 65-74, and ≥75 years) . Findings: During a median 6.0 years of follow-up, 44,396 deaths were documented, with cancer, pneumonia, and CVD being the most common causes of death. When stratified by age group, the strength of the associations between most risk factors and all-cause and cause-specific mortality was strongest in the youngest age group and diminished with increasing age. The eight risk factors explained more population burden of mortality in the youngest (PAF: 51.6%) than the oldest (PAF: 35.3%) age group. In the youngest age group, the strongest population attributable risk factor for all-cause mortality was suboptimal control of blood pressure, followed by CKD. In the oldest age group, CKD and CVD were the largest contributors. CKD contributed most to mortality from CVD and pneumonia in the overall population, while cancer had the greatest PAF for cancer mortality across all age groups. Conclusions: The contribution of each risk factor to mortality in people with type 2 diabetes showed a different pattern across age groups. Age-stratified prevention strategies targeting the major risk factors may have the potential to reduce premature mortality. Disclosure H.Wu: None. A.Luk: None. E.S.H.Lau: None. A.Yang: None. X.Zhang: None. B.Fan: None. R.C.Ma: Other Relationship; Bayer AG, Boehringer Ingelheim International GmbH, Research Support; AstraZeneca, Bayer AG, Novo Nordisk A/S, Pfizer Inc., Tricida, Inc. A.P.Kong: Advisory Panel; Abbott, Kyowa Kirin Co., Ltd., Other Relationship; AstraZeneca, Novo Nordisk, Research Support; Boehringer Ingelheim, Speaker's Bureau; AstraZeneca, Bayer, Eli Lilly and Company, Sanofi, Stock/Shareholder; Aptorum Group Limited. E.Chow: Research Support; Hua Medicine, Medtronic, Powder Pharmaceuticals Inc., Speaker's Bureau; Novartis AG, Sanofi. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer AG, Boehringer Ingelheim International GmbH, Celltrion, Merck Sharp &amp; Dohme Corp., Roche Diabetes Care, Viatris Inc., Research Support; Applied Therapeutics, AstraZeneca, Eli Lilly and Company, Hua Medicine, Servier Laboratories, Stock/Shareholder; GemVCare Ltd.

MO902: Age-Specific Impacts of Risk Factors on All-Cause Mortality in Dialysis Patients

Abstract BACKGROUND AND AIMS Chronic haemodialysis patients expect longer lifespan than previously; they have various backgrounds of mortality risk factors. However, age specific impacts of risk factors on mortality in dialysis patients have rarely been evaluated. Therefore, we aimed to analyze age-specific association between risk factors and all-cause mortality and evaluated differences in the association among age groups. METHOD We conducted a post-hoc analysis of the 461 hypertensive chronic haemodialysis (HD) patients participated in the Olmesartan Clinical Trial in Okinawan Patients Under OKIDS (OCTOPUS) between June 2006 and June 2011. The participants were additionally followed up until 31 July 2018. We stratified the participants into 3 groups (younger patients, n = 156; middle-aged patients, n = 160; elderly patients, n = 145) based on tertile of their ages at their enrollment to the trial. We used age-stratified Cox regression models to assess the association of baseline predictors with all-cause mortality for each age group. In addition, we calculated hazard-ratio based population attributable fraction (PAF) for baseline predictors and all-cause mortality across age groups. RESULTS A median follow-up period of participants was 10.2 years. Means and standard deviations of age for three age groups; younger, middle-aged and elderly patients, were 45.9 ± 6.5, 61.2 ± 3.9 and 72.5 ± 3.3, respectively. The number (%) of deceased patients for the three group was 40 (25.6%), 65 (40.6%) and 106 (73.1%); hazard ratios estimated with Cox regression adjusted for gender and diabetes for the three groups were 1(Reference), 1.43 (0.96–2.14; P = 0.075) and 3.49 (2.41–5.05; P &amp;lt; 0.001), respectively. Age-stratified Cox-regression analyses showed the following associations; diabetes was stably associated with all-cause mortality in all age groups; history of stroke, history of coronary intervention, systolic blood pressure ≥ 170 mmHg and serum phosphate ≥ 6.0 mg/dL had greater impacts on all-cause mortality in younger patients compared with elderly patients; and hypoalbuminemia and hypokalemia had higher impact on all-cause mortality in elderly patients (Figure 1A). We calculated hazard-ratio based PAF for the risk factors to evaluate the difference in impacts of risk factors on all-cause mortality among the age groups; systolic blood pressure ≥ 170mmHg and serum phosphate ≥ 6.0 mg/dL were strongly associated with deaths especially in younger patients (Figure 1B). The total of PAF in elderly patients was almost half of the total of PAF in younger patients. CONCLUSION In chronic haemodialysis patients, associations between risk factors and all-cause mortality are not uniform among different age groups. Vascular disease associated risk factors and hyperphosphatemia were associated with greater risk of morality in younger patients. Hypoalbuminemia and hypokalemia were associated with higher risk of mortality in elderly patients. Proportion of deaths due to modifiable risk factors in elderly HD patients is almost half of that in younger HD patients.