Association between phenotypic age and mortality risk in individuals with obesity: a retrospective cohort study

Front Public Health. 2024 Dec 9:12:1505066. doi: 10.3389/fpubh.2024.1505066. eCollection 2024.

Abstract

Objective: This study investigates the association between phenotypic age acceleration (PAA) and all-cause and cause-specific mortality in obese individuals.

Methods: Data were drawn from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2018, including 9,925 obese adults (BMI ≥ 30 kg/m2). PAA, defined as phenotypic age exceeding chronological age, was assessed using clinical biomarkers. Kaplan-Meier survival analysis and Cox proportional hazards models were used to assess the relationship between PAA and all-cause, cardiovascular, and cancer mortality, adjusting for covariates such as age, gender, race, lifestyle, and health status. Subgroup and sensitivity analyses were performed to ensure the robustness of the findings.

Results: During a median follow-up of 10.6 years, 1,537 deaths were recorded, including 419 from cardiovascular disease and 357 from cancer. PAA was significantly associated with all-cause mortality (HR = 1.84, 95% CI: 1.64-2.06), cardiovascular mortality (HR = 1.86, 95% CI: 1.50-2.31), and cancer mortality (HR = 1.47, 95% CI: 1.17-1.85). These associations remained significant after adjusting for multiple variables, and sensitivity analyses confirmed the robustness of the results.

Conclusion: PAA is an independent predictor of all-cause, cardiovascular, and cancer mortality in obese individuals. This study highlights the importance of PAA in mortality risk assessment and health management in the obese population.

Keywords: NHANES; all-cause mortality; cancer; cardiovascular disease; obesity; phenotypic age acceleration.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Body Mass Index
  • Cardiovascular Diseases* / mortality
  • Cause of Death
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasms* / mortality
  • Nutrition Surveys*
  • Obesity* / mortality
  • Phenotype
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported by China Scholarship Council (Grant No. 201906070289) and Startup Fund for Scientific Research, Fujian Medical University (Grant No. 2022QH1268). The funders had no role in the study design, analysis, decision to publish, nor preparation of the manuscript.