Healthy lifestyle, DNA methylation age acceleration, and incident risk of coronary heart disease

Abstract

Background: DNA methylation clocks emerged as a tool to determine biological aging and have been related to mortality and age-related diseases. Little is known about the association of DNA methylation age (DNAm age) with coronary heart disease (CHD), especially in the Asian population.

Results: Methylation level of baseline blood leukocyte DNA was measured by Infinium Methylation EPIC BeadChip for 491 incident CHD cases and 489 controls in the prospective China Kadoorie Biobank. We calculated the methylation age using a prediction model developed among Chinese. The correlation between chronological age and DNAm age was 0.90. DNA methylation age acceleration (Δage) was defined as the residual of regressing DNA methylation age on the chronological age. After adjustment for multiple risk factors of CHD and cell type proportion, compared with participants in the bottom quartile of Δage, the OR (95% CI) for CHD was 1.84 (1.17, 2.89) for participants in the top quartile. One SD increment in Δage was associated with 30% increased risk of CHD (OR = 1.30; 95% CI 1.09, 1.56; Ptrend = 0.003). The average number of cigarette equivalents consumed per day and waist-to-hip ratio were positively associated with Δage; red meat consumption was negatively associated with Δage, characterized by accelerated aging in those who never or rarely consumed red meat (all P < 0.05). Further mediation analysis revealed that 10%, 5% and 18% of the CHD risk related to smoking, waist-to-hip ratio and never or rarely red meat consumption was mediated through methylation aging, respectively (all P for mediation effect < 0.05).

Conclusions: We first identified the association between DNAm age acceleration and incident CHD in the Asian population, and provided evidence that unfavorable lifestyle-induced epigenetic aging may play an important part in the underlying pathway to CHD.

Keywords: Cardiovascular health; Coronary artery disease; Epigenetic age.

Fig. 1

Subgroup analysis of the association between DNA methylation age acceleration and the risk of incident coronary heart disease according to potential baseline risk factors. Horizontal lines represent 95% CIs. Odds ratio and 95% CI are for the associations of 1-SD Δage increasing with CHD risk. Covariates in the multivariable model: age, sex, education level, marital status, smoking, alcohol drinking, physical activity, average days consuming fresh vegetables, fruits, and red meat per week, body mass index, fasting time, study area, batch, and cell type proportions. * To avoid misleadingly elevated risk, former smokers who stopped smoking for illness were categorized as the current smoker